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The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia

To improve the detection rate of type 2 diabetes, alternative approach to screening have been proposed, such as lower threshold for FPG or the use of HbA1c compared with OGTT, HbA1c measurement is quicker, more convenient, and avoids the need for fasting. Objectives: This study was conducted to e...

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Main Author: Ibrahim, Hasni
Format: Article
Language:English
Published: Japan International Cultural Exchange Foundation 2009
Subjects:
QP1-345 General Including influence of the environment
RC Internal medicine
Online Access:http://eprints.usm.my/57365/1/HASNI%20IBRAHIM.pdf
http://eprints.usm.my/57365/
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spelling my.usm.eprints.57365 http://eprints.usm.my/57365/ The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia Ibrahim, Hasni QP1-345 General Including influence of the environment RC Internal medicine To improve the detection rate of type 2 diabetes, alternative approach to screening have been proposed, such as lower threshold for FPG or the use of HbA1c compared with OGTT, HbA1c measurement is quicker, more convenient, and avoids the need for fasting. Objectives: This study was conducted to evaluate the use of HbA1c as a diagnostic test for diabetes in high risk patient attending Outpatient Clinic at Hospital Universiti Sains Malaysia (HUSM) and to see whether HbA1c is a highly specific test and a convenient alternative to fasting plasma glucose (FPG) or 2-hour postprandial (2-hPP) for diabetes screening. Method: Measurement of FPG, 2-hPP and HbA1c level were performed in 200 subjects, aged 35 years and above with capillary blood glucose ≥ 5.6 mmol/L. The subjects also have at least one cardiovascular risk factor. Results: The mean age and body mass index for study sample were 52.4±9.6 and 26.7±5.0 respectively. The mean of FPG level was 5.7±2.3 mmol/dL, mean of 2-hPP level was 10.0±5.3 mmol/dL and HbA1c level was 6.1 ± 1.5%. Of 200 patients, 40.0% (n = 80) was diagnosed as normal glucose tolerance, 25.5% (n = 51) had impaired fasting glucose and/or impaired glucose tolerance and 34.5% (n = 69) had type 2 diabetes mellitus. The HbA1c of 7.0% gave an optimal sensitivity of 82% and specificity of 91% to predict a FPG " 7.0 mmol/dL. Whereas, HbA1c of 6.4% with sensitivity and specificity of 68% and 87% respectively was an optimal value to predict 2-hPP ≥ ll.lmmol/dL. All together, an HbA1c of 6.4% gave an optimal sensitivity of 68% and specificity of 89% to predict both FPG ≥ 7.0 mmol/dL and/or 2-hPP ≥ ll.lmmol/dL. Conclusion: HbA1c has good sensitivity and specificity to diagnose abnormal glucose tolerance and types 2 diabetes mellitus. Japan International Cultural Exchange Foundation 2009 Article PeerReviewed application/pdf en http://eprints.usm.my/57365/1/HASNI%20IBRAHIM.pdf Ibrahim, Hasni (2009) The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia. International Medical Journal, 16 (2). pp. 125-129. ISSN 1341-2051 (Submitted)
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic QP1-345 General Including influence of the environment
RC Internal medicine
spellingShingle QP1-345 General Including influence of the environment
RC Internal medicine
Ibrahim, Hasni
The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia
description To improve the detection rate of type 2 diabetes, alternative approach to screening have been proposed, such as lower threshold for FPG or the use of HbA1c compared with OGTT, HbA1c measurement is quicker, more convenient, and avoids the need for fasting. Objectives: This study was conducted to evaluate the use of HbA1c as a diagnostic test for diabetes in high risk patient attending Outpatient Clinic at Hospital Universiti Sains Malaysia (HUSM) and to see whether HbA1c is a highly specific test and a convenient alternative to fasting plasma glucose (FPG) or 2-hour postprandial (2-hPP) for diabetes screening. Method: Measurement of FPG, 2-hPP and HbA1c level were performed in 200 subjects, aged 35 years and above with capillary blood glucose ≥ 5.6 mmol/L. The subjects also have at least one cardiovascular risk factor. Results: The mean age and body mass index for study sample were 52.4±9.6 and 26.7±5.0 respectively. The mean of FPG level was 5.7±2.3 mmol/dL, mean of 2-hPP level was 10.0±5.3 mmol/dL and HbA1c level was 6.1 ± 1.5%. Of 200 patients, 40.0% (n = 80) was diagnosed as normal glucose tolerance, 25.5% (n = 51) had impaired fasting glucose and/or impaired glucose tolerance and 34.5% (n = 69) had type 2 diabetes mellitus. The HbA1c of 7.0% gave an optimal sensitivity of 82% and specificity of 91% to predict a FPG " 7.0 mmol/dL. Whereas, HbA1c of 6.4% with sensitivity and specificity of 68% and 87% respectively was an optimal value to predict 2-hPP ≥ ll.lmmol/dL. All together, an HbA1c of 6.4% gave an optimal sensitivity of 68% and specificity of 89% to predict both FPG ≥ 7.0 mmol/dL and/or 2-hPP ≥ ll.lmmol/dL. Conclusion: HbA1c has good sensitivity and specificity to diagnose abnormal glucose tolerance and types 2 diabetes mellitus.
format Article
author Ibrahim, Hasni
author_facet Ibrahim, Hasni
author_sort Ibrahim, Hasni
title The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia
title_short The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia
title_full The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia
title_fullStr The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia
title_full_unstemmed The Use of HbA1c in the Diagnosis of Type 2 Diabetes Mellitus among High Risk Group in Hospital Universiti Sains Malaysia
title_sort use of hba1c in the diagnosis of type 2 diabetes mellitus among high risk group in hospital universiti sains malaysia
publisher Japan International Cultural Exchange Foundation
publishDate 2009
url http://eprints.usm.my/57365/1/HASNI%20IBRAHIM.pdf
http://eprints.usm.my/57365/
_version_ 1761617390049689600
score 13.244403

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