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Rathmann, W.* ; Kowall, B.* ; Tamayo, T.* ; Giani, G.* ; Holle, R. ; Thorand, B. ; Heier, M. ; Huth, C. ; Meisinger, C.

Hemoglobin A1c and glucose criteria identify different subjects as having type 2 diabetes in middle-aged and older populations: The KORA S4/F4 study.

Ann. Med. 44, 170-177 (2012)
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Open Access Green as soon as Postprint is submitted to ZB.
Objective. The American Diabetes Association (ADA) has recently recommended HbA1c for diagnosing diabetes as an alternative to glucose-based criteria. We compared the new HbA1c-based criteria for diagnosis of diabetes and prediabetes with the glucose-based criteria. Research design and methods. In the population-based German KORA surveys (S4/F4) 1,764 non-diabetic participants aged 31-60 years and 896 participants aged 61-75 years underwent measurements of HbA1c, fasting plasma glucose (FPG), and 2-h glucose. Results. Only 20% of all subjects diagnosed with diabetes by glucose or HbA1c criteria had diabetes by both criteria; for prediabetes, the corresponding figure was 23%. Using HbA1c >= 6.5%, the prevalence of diabetes was strongly reduced compared to the glucose criteria (0.7% instead of 2.3% in the middle-aged, 2.9% instead of 7.9% in the older subjects). Only 32.0% (middle-aged) and 43.2% (older group) of isolated impaired glucose tolerance (i-IGT) cases were detected by the HbA1c criterion (5.7% <= HbA1c < 6.5%). Conclusion. By glucose and the new HbA1c diabetes criteria, different subjects are diagnosed with type 2 diabetes in middle-aged as well as older subjects. The new HbA1c criterion lacks sensitivity for impaired glucose tolerance.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Glycosylated Hemoglobin A ; Impaired Fasting Glucose ; Impaired Glucose Tolerance ; Normal Glucose Tolerance ; Oral Glucose Tolerance Test ; Type 2 Diabetes Mellitus; INSULIN-RESISTANCE ATHEROSCLEROSIS; GLYCATED HEMOGLOBIN; LIFE-STYLE; MELLITUS; PREVALENCE; DIAGNOSIS; TOLERANCE; RISK; PERFORMANCE; IMPACT
ISSN (print) / ISBN 0785-3890
e-ISSN 1365-2060
Quellenangaben Volume: 44, Issue: 2, Pages: 170-177 Article Number: , Supplement: ,
Publisher Informa Healthcare
Reviewing status Peer reviewed