Hemoglobin A1c as a Screen for Previously Undiagnosed Prediabetes and Diabetes in an Acute-Care Setting

• DOI: 10.2337/dc10-0996
• Publication Date: 2011-07-21T04:46:36Z
• Authors: Robert A. Silverman; Urvi Thakker; Tovah Ellman; Ivan Wong; Kelly Smith; Kazuhiko Ito; Kirsten Graff
• Keywords: Prediabetes; Gold standard (test); Outpatient clinic

Hemoglobin A(1c) (HbA(1c)) is recommended for identifying diabetes and prediabetes. Because HbA(1c) does not fluctuate with recent eating or acute illness, it can be measured in a variety of clinical settings. Although outpatient studies identified HbA(1c)-screening cutoff values prediabetes, thresholds have been determined acute-care Using follow-up fasting blood glucose (FBG) the 2-h oral tolerance test (OGTT) as criterion gold standard, we optimal cutoffs undiagnosed dysglycemia emergency department setting.This was prospective observational study adults aged ≥18 years no known history hyperglycemia presenting to an illness. Outpatient FBS OGTT were performed after recovery from resulting diagnostic categorizations diabetes, (prediabetes diabetes). Optimal performance data cut points.A total 618 patients included, mean age 49.7 (±14.9) 5.68% (±0.86). On basis OGTT, prevalence previously prediabetes 31.9 10.5%, respectively. The 5.7% (area under curve [AUC] = 0.659, sensitivity 55%, specificity 71%), 5.8% (AUC 0.717, 57%, 79%), 6.0% 0.868, 77%, 87%).We points screen adult population. coincide published findings suggest that visit provides opportunity HbA(1c)-based screening.