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A1c Fails to Diagnose 50% of Diabetes and Prediabetes in Arabs

Oct 7, 2011

Race and ethnicity may influence A1c results and, therefore, the diagnostic accuracy of the test. Researchers examined the sensitivity and specificity of A1c as a diagnostic test for diabetes and prediabetes in 482 non-pregnant Arab adults. A1c levels were 5.9% in 52 individuals with undiagnosed diabetes, 5.2% in 223 individuals with prediabetes, and 5.0% in 207 individuals with normal glucose tolerance. Using the most accurate A1c cut-points of 6.2% for diabetes and 5.1% for prediabetes still failed to diagnose 73% of those with diabetes and 31% of those with prediabetes. A1c results alone correctly identified 5% of individuals with diabetes identified by OGTT, 13% by fasting plasma glucose, and 41% by both criteria. Similarly, A1c results alone correctly identified 14% of individuals with impaired glucose tolerance, 9% with impaired fasting glucose, and 33% with both abnormalities. "In summary," the investigators conclude, "measurement of A1C alone in Arabs results in a high proportion of false-negative test results for both diabetes and prediabetes, which may lead to delayed diagnosis and potential progression of diabetes-related complications. J Clin Endocrinol Metab 2011 online August 17