HbA1c of 6.5% to diagnose Diabetes Mellitus—Does it work for Us?—The Bellville South Africa study
Date
2011-08
Authors
Zemlin, Annalise E.
Matsha, Tandi E.
Hassan, Mogamat S.
Erasmus, Rajiv T.
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science (PLOS)
Abstract
Background: HbA1c has been the gold standard for glycaemic control follow-up for decades. In 2009, a level of 6.5%
(48 mmol/mol) was proposed as diagnostic for diabetes. We test this cut-off in our community.
Methods: Participants (946) from a community-based study were screened for diabetes using either a fasting blood glucose
or oral glucose tolerance test (OFTT). The HbA1c cut-off of 6.5% was tested for each group. A receiver operator characteristic
(ROC) curve for both groups was generated to establish an optimal cut-off.
Results: Our study included 224 (23.7%) males and 722 (76.3%) females. Using fasting blood glucose alone, 117 (14%) were
diagnosed with diabetes 250% had an HbA1c value of $6.5% (48 mmol/mol). Using an OGTT, 147 (18%) were diagnosed
with diabetes 246% had an HbA1c value of $6.5% (48 mmol/mol). ROC curves found a level of 6.1% (43 mmol/mol) to be
optimal in both groups (AUC 0.85 and 0.82 respectively). The sensitivities were 80% and 75% and the specificities 77% and
78% respectively. Conclusions: A cut off of 6.5% (48 mmol/mol) is a good diagnostic tool with its high specificity; however the low sensitivity limits its use. We found a level of 6.1% (43 mmol/mol) to be optimal. This emphasizes the need for evidenced based values
to be established in various population groups.
Description
The original publication is available at http:/www.plosone.org
Bibliography
Bibliography
Keywords
Diabetes mellitus -- Effect of HbAlc on, Diabetes mellitus -- Diagnosis -- Western Cape -- Bellville -- Case study, Glycaemic control, Diabetes mellitus -- Treatment -- Western Cape -- Bellville -- Case studies
Citation
Zemlin, A. E., Matsha, T. E., Hassan, M. S. & Erasmus, R.T. 2011. HbA1c of 6.5% to diagnose Diabetes Mellitus—Does It Work for Us?—The Bellville South Africa Study. PLoS ONE, 6(8), e22558, doi:10.1371/journal.pone.0022558.