HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.

Soraya Soulimane, Dominique Simon, Jonathan Shaw, Daniel Witte, Paul Zimmet, Sylviane Vol, Knut Borch-Johnsen, Dianna Magliano, Dorte Vistisen, Beverley Balkau

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Introduction: With diabetes defined by HbA1c ≥ 6.5% and/or FPG ≥ 7.0. mmol/l and/or diabetes treatment, we investigated HbA1c and fasting plasma glucose (FPG) thresholds/change-points above which the incidence of diabetes increases. Methods: Data are Danish (Inter99), Australian (AusDiab) and French (D.E.S.I.R.), with respectively 4930, 6012 and 3784 non-diabetic participants. Results: Diabetes incidences at 5 years for Inter99 and AusDiab and at 6 years for D.E.S.I.R. were 2.3%, 3.1% and 2.4% respectively and incidences increased with baseline HbA1c and FPG. As HbA1c distributions differed between cohorts, HbA1c was standardized on D.E.S.I.R. data. Change-points where diabetes incidence increased were identified for HbA1c (%) after standardization: 5.1 (4.9-5.6) (Inter99), 5.4 (5.1-5.6) (AusDiab), 5.3 (5.1-5.7) (D.E.S.I.R.); for FPG change-points (mmol/l) were 5.1 (...-6.1) (Inter99), 5.5 (5.2-5.8) (AusDiab), no change-point for D.E.S.I.R. Using current diabetes risk criteria HbA1c ≥ 5.7% and/or FPG ≥ 5.6. mmol/l to screen for diabetes provided high sensitivity (over 89%) and positive predictive values: 4.3%, 6.9%, and 5.9% respectively. Conclusions: HbA1c and FPG change-points predicting incident diabetes did not always exist, differed across studies, when available were generally lower than current criteria with wide confidence intervals. Using jointly HbA1c ≥ 5.7% and/or FPG ≥ 5.6. mmol/l as a criterion for the risk of incident diabetes is appropriate.

LanguageEnglish
Pages392-399
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume96
Issue number3
DOIs
Publication statusPublished - 1 Jun 2012

Keywords

  • Diabetes
  • Epidemiology
  • Fasting plasma glucose
  • HbA1c

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Soulimane, Soraya ; Simon, Dominique ; Shaw, Jonathan ; Witte, Daniel ; Zimmet, Paul ; Vol, Sylviane ; Borch-Johnsen, Knut ; Magliano, Dianna ; Vistisen, Dorte ; Balkau, Beverley. / HbA1c, fasting plasma glucose and the prediction of diabetes : Inter99, AusDiab and D.E.S.I.R. In: Diabetes Research and Clinical Practice. 2012 ; Vol. 96, No. 3. pp. 392-399.
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title = "HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.",
abstract = "Introduction: With diabetes defined by HbA1c ≥ 6.5{\%} and/or FPG ≥ 7.0. mmol/l and/or diabetes treatment, we investigated HbA1c and fasting plasma glucose (FPG) thresholds/change-points above which the incidence of diabetes increases. Methods: Data are Danish (Inter99), Australian (AusDiab) and French (D.E.S.I.R.), with respectively 4930, 6012 and 3784 non-diabetic participants. Results: Diabetes incidences at 5 years for Inter99 and AusDiab and at 6 years for D.E.S.I.R. were 2.3{\%}, 3.1{\%} and 2.4{\%} respectively and incidences increased with baseline HbA1c and FPG. As HbA1c distributions differed between cohorts, HbA1c was standardized on D.E.S.I.R. data. Change-points where diabetes incidence increased were identified for HbA1c ({\%}) after standardization: 5.1 (4.9-5.6) (Inter99), 5.4 (5.1-5.6) (AusDiab), 5.3 (5.1-5.7) (D.E.S.I.R.); for FPG change-points (mmol/l) were 5.1 (...-6.1) (Inter99), 5.5 (5.2-5.8) (AusDiab), no change-point for D.E.S.I.R. Using current diabetes risk criteria HbA1c ≥ 5.7{\%} and/or FPG ≥ 5.6. mmol/l to screen for diabetes provided high sensitivity (over 89{\%}) and positive predictive values: 4.3{\%}, 6.9{\%}, and 5.9{\%} respectively. Conclusions: HbA1c and FPG change-points predicting incident diabetes did not always exist, differed across studies, when available were generally lower than current criteria with wide confidence intervals. Using jointly HbA1c ≥ 5.7{\%} and/or FPG ≥ 5.6. mmol/l as a criterion for the risk of incident diabetes is appropriate.",
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Soulimane, S, Simon, D, Shaw, J, Witte, D, Zimmet, P, Vol, S, Borch-Johnsen, K, Magliano, D, Vistisen, D & Balkau, B 2012, 'HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.', Diabetes Research and Clinical Practice, vol. 96, no. 3, pp. 392-399. https://doi.org/10.1016/j.diabres.2011.06.003

HbA1c, fasting plasma glucose and the prediction of diabetes : Inter99, AusDiab and D.E.S.I.R. / Soulimane, Soraya; Simon, Dominique; Shaw, Jonathan; Witte, Daniel; Zimmet, Paul; Vol, Sylviane; Borch-Johnsen, Knut; Magliano, Dianna; Vistisen, Dorte; Balkau, Beverley.

In: Diabetes Research and Clinical Practice, Vol. 96, No. 3, 01.06.2012, p. 392-399.

Research output: Contribution to journalArticle

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T1 - HbA1c, fasting plasma glucose and the prediction of diabetes

T2 - Diabetes Research and Clinical Practice

AU - Soulimane, Soraya

AU - Simon, Dominique

AU - Shaw, Jonathan

AU - Witte, Daniel

AU - Zimmet, Paul

AU - Vol, Sylviane

AU - Borch-Johnsen, Knut

AU - Magliano, Dianna

AU - Vistisen, Dorte

AU - Balkau, Beverley

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Introduction: With diabetes defined by HbA1c ≥ 6.5% and/or FPG ≥ 7.0. mmol/l and/or diabetes treatment, we investigated HbA1c and fasting plasma glucose (FPG) thresholds/change-points above which the incidence of diabetes increases. Methods: Data are Danish (Inter99), Australian (AusDiab) and French (D.E.S.I.R.), with respectively 4930, 6012 and 3784 non-diabetic participants. Results: Diabetes incidences at 5 years for Inter99 and AusDiab and at 6 years for D.E.S.I.R. were 2.3%, 3.1% and 2.4% respectively and incidences increased with baseline HbA1c and FPG. As HbA1c distributions differed between cohorts, HbA1c was standardized on D.E.S.I.R. data. Change-points where diabetes incidence increased were identified for HbA1c (%) after standardization: 5.1 (4.9-5.6) (Inter99), 5.4 (5.1-5.6) (AusDiab), 5.3 (5.1-5.7) (D.E.S.I.R.); for FPG change-points (mmol/l) were 5.1 (...-6.1) (Inter99), 5.5 (5.2-5.8) (AusDiab), no change-point for D.E.S.I.R. Using current diabetes risk criteria HbA1c ≥ 5.7% and/or FPG ≥ 5.6. mmol/l to screen for diabetes provided high sensitivity (over 89%) and positive predictive values: 4.3%, 6.9%, and 5.9% respectively. Conclusions: HbA1c and FPG change-points predicting incident diabetes did not always exist, differed across studies, when available were generally lower than current criteria with wide confidence intervals. Using jointly HbA1c ≥ 5.7% and/or FPG ≥ 5.6. mmol/l as a criterion for the risk of incident diabetes is appropriate.

AB - Introduction: With diabetes defined by HbA1c ≥ 6.5% and/or FPG ≥ 7.0. mmol/l and/or diabetes treatment, we investigated HbA1c and fasting plasma glucose (FPG) thresholds/change-points above which the incidence of diabetes increases. Methods: Data are Danish (Inter99), Australian (AusDiab) and French (D.E.S.I.R.), with respectively 4930, 6012 and 3784 non-diabetic participants. Results: Diabetes incidences at 5 years for Inter99 and AusDiab and at 6 years for D.E.S.I.R. were 2.3%, 3.1% and 2.4% respectively and incidences increased with baseline HbA1c and FPG. As HbA1c distributions differed between cohorts, HbA1c was standardized on D.E.S.I.R. data. Change-points where diabetes incidence increased were identified for HbA1c (%) after standardization: 5.1 (4.9-5.6) (Inter99), 5.4 (5.1-5.6) (AusDiab), 5.3 (5.1-5.7) (D.E.S.I.R.); for FPG change-points (mmol/l) were 5.1 (...-6.1) (Inter99), 5.5 (5.2-5.8) (AusDiab), no change-point for D.E.S.I.R. Using current diabetes risk criteria HbA1c ≥ 5.7% and/or FPG ≥ 5.6. mmol/l to screen for diabetes provided high sensitivity (over 89%) and positive predictive values: 4.3%, 6.9%, and 5.9% respectively. Conclusions: HbA1c and FPG change-points predicting incident diabetes did not always exist, differed across studies, when available were generally lower than current criteria with wide confidence intervals. Using jointly HbA1c ≥ 5.7% and/or FPG ≥ 5.6. mmol/l as a criterion for the risk of incident diabetes is appropriate.

KW - Diabetes

KW - Epidemiology

KW - Fasting plasma glucose

KW - HbA1c

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