scholarly journals Hemoglobin A1c Versus Oral Glucose Tolerance Test in Postpartum Diabetes Screening

Diabetes Care ◽  
2012 ◽  
Vol 35 (8) ◽  
pp. 1648-1653 ◽  
Author(s):  
M. J. Picon ◽  
M. Murri ◽  
A. Munoz ◽  
J. C. Fernandez-Garcia ◽  
R. Gomez-Huelgas ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Hemoglobin A1c ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Diabetes Screening ◽  
Postpartum Diabetes

scholarly journals Increased Hemoglobin A1c Threshold for Prediabetes Remarkably Improving the Agreement Between A1c and Oral Glucose Tolerance Test Criteria in Obese Population

2015 ◽  
Vol 100 (5) ◽  
pp. 1997-2005 ◽  
Author(s):  
Jie Li ◽  
Hao Ma ◽  
Lixin Na ◽  
Shuo Jiang ◽  
Lin Lv ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Hemoglobin A1c ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Normal Weight ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Cutoff Values ◽  
Obese Population

Abstract Context: It is unclear why the prevalence of diabetes and prediabetes, especially prediabetes, between diagnosed by oral glucose tolerance test (OGTT) and hemoglobin A1c (HbA1c) criteria, is substantially discordant. Objective: We aimed to evaluate the effects of obesity on the agreement between HbA1c and OGTT for diagnosing diabetes and prediabetes and identify the optimal HbA1c cutoff values in different body mass index (BMI) classifications. Design Setting and Participants: In a population-based, cross-sectional study in Harbin, China, 4325 individuals aged 20–74 years without a prior diagnosed diabetes were involved in this study. Outcome: measure The performance and optimal cutoff points of HbA1c were assessed by receiver-operating characteristic curve. The contribution of BMI to HbA1c was analyzed by structural equational model. Results: The agreement between HbA1c criteria and OGTT decreased with BMI gain (κ = 0.359, 0.312, and 0.275 in a normal weight, overweight, and obese population, respectively). The structural equational model results showed that BMI was significantly associated with HbA1c in normal glucose tolerance and prediabetes subjects but not in diabetes subjects. At a specificity of 80% for prediabetes and 97.5% for diabetes, the optimal HbA1c cutoff points for prediabetes and diabetes were 5.6% and 6.4% in normal-weight, 5.7% and 6.5% in overweight, and 6.0% and 6.5% in an obese population. When the new HbA1c cutoff values were used, the agreement in obese subjects increased almost to the level in normal-weight subjects. Conclusions: The poor agreement between HbA1c and OGTT criteria in an obese population can be significantly improved through increasing the HbA1c threshold for prediabetes.

Is Serum Anhydroglucitol an Alternative to the Oral Glucose Tolerance Test for Diabetes Screening?

1993 ◽  
Vol 10 (1) ◽  
pp. 56-60 ◽  
Author(s):  
D.A. Robertson ◽  
K.G.M.M. Alberti ◽  
G.K. Dowse ◽  
P. Zimmet ◽  
J. Tuomilehto ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Diabetes Screening

scholarly journals Comparison of 2-Hour Oral Glucose Tolerance Test and Hemoglobin A1C in the Identification of Pre-Diabetes in Women with Infertility and Recurrent Pregnancy Loss

2019 ◽  
Vol 13 ◽  
pp. 117955811983128 ◽  
Author(s):  
Alice J Shapiro ◽  
Emily C Holden ◽  
Peter G McGovern ◽  
Donald Alderson ◽  
Sara S Morelli
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Gold Standard ◽  
Pregnancy Loss ◽  
Hemoglobin A1c ◽  
Recurrent Pregnancy Loss ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Research question: Does hemoglobin A1C (HbA1C) predict pre-diabetes (pre-DM) in a population of women with infertility and/or recurrent pregnancy loss (RPL), when considering the 75 g, 2-hour oral glucose tolerance test (2h GTT) as the gold standard? Design: Retrospective study of 242 patients with infertility or RPL presenting to a university-affiliated reproductive endocrinology and infertility clinic between January 2012 and December 2016 who underwent screening for disorders of glucose metabolism with a 2h GTT. The prevalence of pre-DM as defined by HbA1C 5.7% to 6.4% and 2h GTT values of 140-199 mg/dL, and predictive values of HbA1C for the identification of pre-DM when compared with 2h GTT, were calculated and compared. Results: Of 242 patients, 188 (77.7%) women had both HbA1C and 2h GTT performed. Of these, 89 (47.3%) tested positive for pre-DM by one or both methods. Of 89 patients, 14 (15.7%) had both an abnormal 2h GTT and an abnormal HbA1C. Only 6 out of 89 (6.7%) patients tested positive for pre-DM by an abnormal 2h GTT in the setting of a normal HbA1C result. Conversely, 69 of these 89 patients (77.5%) tested positive for pre-DM by an abnormal HbA1C in the setting of a normal 2h GTT. The prevalence of pre-DM, as defined by 2h GTT, was 10.6% (20/188) (95% CI, 6.6-16.0), compared with a prevalence of 44.1% (83/188) (95% CI, 36.9-51.6) when pre-DM was defined by HbA1C alone. When the 2h GTT was considered the gold standard for the identification of pre-DM, the negative predictive value (NPV) of HbA1C compared with 2h GTT was 94.3% (95% CI, 88.0-97.9), whereas the positive predictive value (PPV) of HbA1C compared with 2h GTT was only 16.9% (95% CI, 9.5-26.7). Conclusions: Although a normal HbA1C was highly predictive of a normal 2h GTT, the two tests demonstrate poor agreement in the identification of pre-DM in women with infertility and/or RPL. Hemoglobin A1C is superior to the 2h GTT as an initial screening test for pre-DM in this population, since it identified a substantial number of women who would otherwise remain undiagnosed in the setting for a normal 2h GTT alone. However, the long-term clinical relevance of an elevated HbA1C in this population needs to be better defined.

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