Abstract
Aim
The methods used for diagnosis of diabetes have limitations particularly in situations
associated with stress hyperglycemia. Aim of this study was to evaluate the performance
of A1c and fasting plasma glucose (FPG) tests for screening newly diagnosed diabetes (NDD)
defined by OGTT among tuberculosis (TB) cases in India.
Methods
A total of 983 subjects aged ≥18 years with TB were selected from 7 TB units – 4 urban,
2 rural and 1 semi-urban areas of Tamil Nadu, India, during August 2010–March 2011.
Screening for diabetes was carried out by 2-h 75 g OGTT. Classification of glucose intolerance status was based on WHO criteria. HbA1c was measured by high performance liquid chromatography using Bio-Rad turbo machine.
HbA1c ≥ 47.5 mmol/mol was used for diagnosis of diabetes. FPG was estimated by glucose-oxidase
method. Known cases of subjects with diabetes were excluded and final analysis was
done using data of 779 individuals. The performance of A1c and FPG tests was evaluated against the results of OGTT using receiver operating
characteristic curve analysis.
Results
Prevalence of NDD was 10.8%. The areas under the curve (AUC) were 0.754 [95% confidence
interval (CI) 0.68–0.83] (p < 0.001) for A1c and 0.662 (95% CI 0.58–0.74) for FPG (p < 0.001) in NDD subjects. The HbA1c cut-off point of ≥47.5 mmol/mol gave a sensitivity of 59.1% and specificity of 91.7%, and the respective
values were 34.8% and 97.5% for FPG in subjects with NDD.
Conclusion
HbA1c performed better than FPG as a screening tool for newly diagnosed diabetes among
subjects with TB.
Keywords
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Article info
Publication history
Published online: September 16, 2013
Accepted:
August 23,
2013
Received in revised form:
May 4,
2013
Received:
December 10,
2012
Footnotes
☆Data from the manuscript have been presented at The American Diabetes Association's 72nd Scientific Sessions, June 8–12, 2012, at Pennsylvania Convention Center, Philadelphia, PA.
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
