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  • SEPTEMBER 2020 Issue has been successfully launched on 1 September 2020.

Abstract

A COMPARISON BETWEEN HbA1c AND FASTING PLASMA GLUCOSE IN THE DIAGNOSIS OF TYPE 2 DIABETES IN TRINIDAD A HIGH PREVALENCE SETTING

*B Shivananda Nayak, Kameel Mungrue, Shawn Seepersad, Justin Sookram, Shalina Singh, Crystal Skeete, Cadina Samaroo, Victoria Seebalack, Nirvani Siraramsingh, Munish Sharma

The University of the West Indies, Faculty of Medical Sciences, Departments of Pre and Para Clinical Sciences, St. Augustine, Trinidad.

ABSTRACT

Objective: To compare the performance of fasting plasma glucose with HbA1c in the diagnosis of type 2 diabetes in Trinidad. Methods: The study was a community based prospective study of patients referred to a large teaching hospital for the laboratory confirmation of type 2 diabetes. Patients with no prior confirmation of type 2 diabetes mellitus were eligible for entry into the study. On entry into the study venous blood samples were taken for both fasting plasma glucose and HbA1c. Results: Of the 308 patients entered into the study using a FPG>128mg/dl, 102 (33.1%) patients were classified as having type 2 diabetes mellitus. 64 (20.8%) patients were classified as having IFG (110-125mg/dl) and the remaining 142 (46.1%) patients were classified as euglycaemic (plasma glucose <110mg/dl). On the other hand 152(49.4%) participants had an HbA1c assay >6.5% and were classified as having type 2 diabetes mellitus. In other words more participants (50, 16%) were classified with diabetes using HbA1c. Conclusion: Against an HbA1c >= 6.5% a single fasting glucose >=126 mg/dl, the sensitivity and specificity for detection of diabetes was 57% and 90%, respectively (AUC 0.79). HbA1c has a strong correlation (r=0.72) with fasting blood glucose above 126mg/dl. HbA1c classified more people as diabetic (49.4%) compared to FPG (33.1%).

Keywords: Type 2 diabetes, HbA1c, fasting plasma glucose.


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