1. Isolated HbA1c identifies a different subgroup of individuals with type 2 diabetes compared to fasting or post-challenge glucose in Asian Indians: The CARRS and MASALA studies.
- Author
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Gujral, U.P., Prabhakaran, D., Pradeepa, R., Kandula, N.R., Kondal, D., Deepa, M., Zakai, N.A., Anjana, R.M., Rautela, G., Mohan, V., Narayan, K.M.V., Tandon, N., and Kanaya, A.M.
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INDIANS (Asians) , *TYPE 2 diabetes , *GLUCOSE , *GLUCOSE intolerance , *FASTING , *RESEARCH , *CROSS-sectional method , *RESEARCH methodology , *ARTHRITIS Impact Measurement Scales , *BLOOD sugar , *EVALUATION research , *COMPARATIVE studies , *RESEARCH funding - Abstract
Aims: Guidelines recommend hemoglobin A1c (HbA1c) as a diagnostic test for type 2 diabetes, but its accuracy may differ in certain ethnic groups.Methods: The prevalence of type 2 diabetes by HbA1c, fasting glucose, and 2 h glucose was compared in 3016 participants from Chennai and Delhi, India from the CARRS-2 Study to 757 Indians in the U.S. from the MASALA Study. Type 2 diabetes was defined as fasting glucose ≥ 7.0 mmol/L, 2-h glucose ≥ 11.1 mmol/L, or HbA1c ≥ 6.5%. Isolated HbA1c diabetes was defined as HbA1c ≥ 6.5% with fasting glucose < 7.0 mmol/L and 2 h glucose < 11.1 mmol/L.Results: The age, sex, and BMI adjusted prevalence of diabetes by isolated HbA1c was 2.9% (95% CI: 2.2-4.0), 3.1% (95% CI: 2.3-4.1), and 0.8% (95% CI: 0.4-1.8) in CARRS-Chennai, CARRS-Delhi, and MASALA, respectively. The proportion of diabetes diagnosed by isolated HbA1c was 19.4%, 26.8%, and 10.8% in CARRS-Chennai, CARRS-Delhi, and MASALA respectively. In CARRS-2, individuals with type 2 diabetes by isolated HbA1c milder cardio-metabolic risk than those diagnosed by fasting or 2-h measures.Conclusions: In Asian Indians, the use of HbA1c for type 2 diabetes diagnosis could result in a higher prevalence. HbA1c may identify a subset of individuals with milder glucose intolerance. [ABSTRACT FROM AUTHOR]- Published
- 2019
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