• G B Viñes, M Roubicek, and A González Sanguineti.
• Hospital Privado de Comunidad, Mar del Plata, Argentina. statti@infovia.com.ar
• Medicina (B Aires). 1998 Jan 1; 58 (6): 728732728-32.

AbstractA series of 405 consecutive oral glucose tolerance tests was analyzed in comparison with simultaneous glycosylated hemoglobin (HbA1c) measurements, in order to ascertain the possible utility of HbA1c as an alternative method for diagnosis and screening in populations suspected or at increased risk of presenting diabetes mellitus. The study group consisted of 158 male and 247 nonpregnant female patients aged 3 to 84 years (median 61.5 and 56 years, respectively) referred by their physicians for diagnostic purposes. Tolerance test was performed according to usual methods and HbA1c was measured with the 2000 DC immunoassay. Results showed a good correlation between HbA1c and fasting or 2 hour glucose levels. Using WHO diagnostic criteria, HbA1c maximal normal level of 5.4% showed a sensitivity of 0.96 in distinguishing between non-diabetics and those at increased risk, for screening purposes. With HbA1c levels of 6.0 or 6.3%, specificity for a correct diagnosis of diabetes was high (0.94 or 0.97) making this a suitable level for diagnostic confirmation. With the new ADA criteria for fasting plasma glucose, the results were similar. We suggest that HbA1c measurement with highly accurate methods might be considered a valid alternative for diagnosis and screening in populations suspected or at increased risk of presenting diabetes mellitus.

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