Sensitivity of A1C to diagnose diabetes is decreased in high-risk older Southeast Asians

J Diabetes Complications. 2012 Mar-Apr;26(2):99-101. doi: 10.1016/j.jdiacomp.2012.02.007. Epub 2012 Mar 31.

Abstract

Objective: To determine the effect of ageing on the performance of glycosylated haemoglobin A1C (A1C) for the diagnosis of diabetes mellitus (DM) in Southeast Asians.

Methods: A1C was measured in 511 subjects (mean age of 52.4 years; range 14-93) undergoing the 75-g oral glucose tolerance test (OGTT). Using receiver operating curve (ROC) analysis, the performance of A1C for the diagnosis of diabetes (using different standard criteria) was compared between 4 groups: <45 (n=156), 45-54 (n=132), 55-64 (n=122), ≥65 years (n=101).

Results: Subjects aged ≥65 years had the highest false-negative rates with fasting plasma glucose (60.8%) and A1C (35.1%), the smallest area under ROC curve (0.723, 95% CI 0.627-0.820), the lowest sensitivity (58.7%, 95% CI 50.4-65.7) and specificity (71.1%, 95% CI 57.3-82.6) of A1C 6.5%, compared to the younger age groups.

Conclusion: OGTT is preferable for diagnosis of DM in older Southeast Asian adults.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • False Negative Reactions
  • Fasting / blood
  • Female
  • Glucose Tolerance Test
  • Glycated Hemoglobin / analysis*
  • Humans
  • Male
  • Middle Aged
  • ROC Curve
  • Risk
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human