Combined HbA1c and fasting glucose best for diabetes prediction
MedWire News: Results from the TOPICS 3 study show that combining glycated hemoglobin (HbA1c) with fasting glucose results in more accurate diabetes prediction than either measure alone.
HbA1c testing is now recommended for diagnosis of Type 2 diabetes; however, the relevance of these criteria for assessing the risk for developing diabetes is less clear.
Yoriko Heianza (University of Tsukuba, Ibaraki, Japan) presented the results of the TOPICS 3 longitudinal cohort study at the American Diabetes Association annual scientific sessions in San Diego, USA. The results were simultaneously published online in the Lancet.
The study evaluated the ability of HbA1c alone, fasting glucose alone, and a combination of the two factors to predict incident Type 2 diabetes in 6241 initially nondiabetic men and women over 4.7 years of follow-up.
Participants were considered at risk or "prediabetic" if they had an HbA1c level of 5.7-6.4% (n=412), a fasting glucose level of 5.6-6.9 mmol/l (n=1270), or a combination of the two (n=410).
The team found that baseline prediabetes defined by impaired fasting glucose alone was slightly more accurate for incident diabetes prediction than prediabetes defined by HbA1c alone, with the former associated with a significant 6.16-fold and the latter a 6.00-fold increase in risk for diabetes compared with baseline normoglycemia.
Participants who had baseline prediabetes according to both definitions had a significantly higher 31.9-fold increase in risk for incident Type 2 diabetes over the follow-up period compared with those who had baseline normoglycemia, showing that clinicians should use a combination of both measures for an optimum prediction of diabetes risk.
"These two tests together could efficiently target people who are most likely to develop diabetes and allow for early intervention," suggest the researchers.
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By Helen Albert