[ Diabetes Type 1 ]

Longitudinal Validation of Hemoglobin A1c Criteria for Diabetes Diagnosis: Risk of Retinopathy


A1C is a measure of blood sugar over time. The test has been recommended for years as a measure of how well people are doing to keep their blood glucose levels under control. The authors showed that treatments to reduce blood sugar only delayed the onset of type 2 diabetes by a few years, and found no evidence of long-term health benefits. Prediabetic subjects who met HbA1c criteria only were significantly older, more likely to be women, and had lower hemoglobin and serum iron concentrations, whereas those who met FPG criteria only had higher body mass index, waist circumference, systolic and diastolic blood pressure. In conclusion, introduction of HbA1c criterion markedly increased the prevalence of prediabetes in Koreans, and the two criteria identified people with different characteristics. With the increasing prevalence of diabetes in the Asia Pacific region coupled with the limited number of resources, use of a reliable and effective mode of diagnosis for T2DM is warranted. The A1C test would join the fasting plasma glucose, or FPG, test (which involves measuring the amount of glucose in a person’s blood after at least eight hours without food or drink) and the oral glucose tolerance test, or OGTT (which measures a person’s blood glucose response to the consumption of a glucose-rich drink after at least eight hours without food or drink) as diagnostic tools for diabetes and prediabetes.

Bowker’s Test of Symmetry was employed to determine agreement between the tests. In the study, researchers compared scores on two different tests for diabetes in about 5,000 Americans who had not been diagnosed with the disease. The doctor diagnosed me with a very extreme case of Type 2 Diabetes, along with extremely high cholesterol. This can be attributed to limited power with the smaller studies; in addition, in some studies the hemoglobin A1c levels were not analyzed in ranges that permit examining the 6.5% cut-off point specifically. “So that stopped. The A1C would join two previous diagnostic tests for diabetes, Fasting Plasma Glucose (FPG) and the Oral Glucose Tolerance Test (OGTT), both of which require overnight fasting.

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