Moving to an HbA1c based diagnosis of diabetes has a different impact on prevalence in different ethnic groups

• Main Authors: Christensen, Dirk L., Witte, Daniel R., Kaduka, Lydia, Jørgensen, Marit E., Borch-Johnsen, Knut, Mohan, Viswanathan, Shaw, Jonathan E., Tabàk, Adam G., Vistisen, Dorte
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: American Diabetes Association 2009
• Subjects: R Medicine; Greenland
• Online Access: http://repository.ias.ac.in/84427/; http://care.diabetesjournals.org/content/early/2009/12/14/dc09-1843

Objective: To compare screen detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current OGTT-based and newly proposed HbA 1c -based diagnostic criteria. Research design and methods: Six studies (1999-2009) from Denmark, United Kingdom, Australia, Greenland, Kenya, and India were tested for the probability of an HbA 1c ≥ 6.5% among diabetes cases based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. Results: Diabetes prevalence was lower with the HbA 1c -based diagnostic criteria in four out of six studies. The probability of an HbA 1c ≥ 6.5% among OGTT-diagnosed cases ranged widely (17.0 to 78.0%) by study center. Differences in diagnostic agreement between ethnic sub-groups in the United Kingdom study were of the same magnitude as between-country comparisons. Conclusions: A shift to an HbA 1c -based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.