Journal
DIABETES CARE
Volume 33, Issue 3, Pages 580-582Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc09-1843
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Funding
- MRC [G0501184] Funding Source: UKRI
- Medical Research Council [G0501184] Funding Source: researchfish
- British Heart Foundation Funding Source: Medline
- Medical Research Council [G0501184] Funding Source: Medline
- NHLBI NIH HHS [R01 HL036310, HL36310] Funding Source: Medline
- NIA NIH HHS [R01 AG013196, R37 AG013196, AG13196] Funding Source: Medline
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OBJECTIVE - To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current Oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. RESEARCH DESIGN AND METHODS - Six studies (1999-2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C >= 6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. RESULTS - Diabetes prevalence was lower with the A1C-based diagnostic Criteria in four of six studies. The probability of an A1C >= 6.5% among OGTT-diagnosed case subjects ranged widely (17.0-78.0%) by Study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. Study were of the same magnitude as between-country comparisons. CONCLUSIONS - A shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.
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