Low positive predictive value of hemoglobin a1c for diagnosis of prediabetes in clinical practice

Aidar R. Gosmanov, Jim Wan

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Positive predictive value (PPV) of hemoglobin A1c (HbA1c) for diagnosis of prediabetes in clinical practice has not been well studied. METHODS: In a prospective study, patients diagnosed with prediabetes based on HbA1c (5.7%-6.4%) underwent a 75-g oral glucose tolerance test (OGTT) as the gold standard test to diagnose dysglycemia. Demographics, anthropometrics, comorbidity, concomitant prescription medications and biochemical data were collected. RESULTS: We identified 66 patients with HbA1c-based prediabetes with a mean HbA1c of 6.00 ± 0.20%. However, based on the OGTT, 32 had normal glucose tolerance (NGT), 26 had prediabetes and 8 had diabetes yielding a PPV of HbA1c of 39.4%. In univariate analysis, the patients with the OGTT-based prediabetes administered more medications for associated medical problems compared with the NGT group (5.9 ± 2.2 versus 2.6 ± 1.8, P < 0.0001). After adjustment for baseline variables, the medication use remained significantly different between OGTT-based prediabetes and NGT groups (P = 0.041). CONCLUSIONS: PPV of HbA1c for diagnosis of prediabetes in clinical setting is low. Patients with HbA1c of 5.7% to 6.4% should undergo OGTT to confirm diagnosis of dysglycemia.

Original languageEnglish (US)
Pages (from-to)191-194
Number of pages4
JournalAmerican Journal of the Medical Sciences
Volume348
Issue number3
DOIs
StatePublished - Jan 1 2014

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Prediabetic State
Hemoglobins
Glucose Tolerance Test
Glucose
Prescriptions
Comorbidity
Demography
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Low positive predictive value of hemoglobin a1c for diagnosis of prediabetes in clinical practice. / Gosmanov, Aidar R.; Wan, Jim.

In: American Journal of the Medical Sciences, Vol. 348, No. 3, 01.01.2014, p. 191-194.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Positive predictive value (PPV) of hemoglobin A1c (HbA1c) for diagnosis of prediabetes in clinical practice has not been well studied. METHODS: In a prospective study, patients diagnosed with prediabetes based on HbA1c (5.7{\%}-6.4{\%}) underwent a 75-g oral glucose tolerance test (OGTT) as the gold standard test to diagnose dysglycemia. Demographics, anthropometrics, comorbidity, concomitant prescription medications and biochemical data were collected. RESULTS: We identified 66 patients with HbA1c-based prediabetes with a mean HbA1c of 6.00 ± 0.20{\%}. However, based on the OGTT, 32 had normal glucose tolerance (NGT), 26 had prediabetes and 8 had diabetes yielding a PPV of HbA1c of 39.4{\%}. In univariate analysis, the patients with the OGTT-based prediabetes administered more medications for associated medical problems compared with the NGT group (5.9 ± 2.2 versus 2.6 ± 1.8, P < 0.0001). After adjustment for baseline variables, the medication use remained significantly different between OGTT-based prediabetes and NGT groups (P = 0.041). CONCLUSIONS: PPV of HbA1c for diagnosis of prediabetes in clinical setting is low. Patients with HbA1c of 5.7{\%} to 6.4{\%} should undergo OGTT to confirm diagnosis of dysglycemia.",
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