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Acceptability of HbA1c values as a diagnostic tool for diabetes mellitus in Korea  

Jung, Jang-Han (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Kim, Sung-Tae (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Cho, Youn-Zoo (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Lee, Han-Na (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Kim, Ji-Young (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Kim, Ji-Hye (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Lim, Dong-Mi (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Lee, Kang-Woo (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Kim, Byung-Jun (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Park, Kuen-Yong (Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine)
Publication Information
The Korean Journal of Medicine / v.79, no.6, 2010 , pp. 673-680 More about this Journal
Abstract
Background/Aims: In 2010, the American Diabetes Association (ADA) adopted glycated hemoglobin (HbA1c) as a new diagnostic criterion for diabetes mellitus. However, HbA1c values may differ among races. We determined whether this criterion could be applied to Korean diabetics. Methods: Between January 2000 and January 2010, 1,862 patients among Konyang University Hospital visitors in which the 75 g oral glucose tolerance test (OGTT) and HbA1c were checked at the same time were enrolled. We excluded patients with acute disease, an Hb ${\leq}$ 10 g/dL, a Cr ${\geq}$ 2 mg/dL, those prescribed oral hypoglycemic agents or insulin, and those who were pregnant. Results: After applying the exclusion criteria, 1,474 Korean patients were enrolled. All had common features of Korean diabetics for body mass index and homeostatic model assessment of insulin resistance values. Using the 0 and 120 minute glucose levels of the OGTT from the receiver operating characteristic curve, the HbA1c cutoff value was 6.25%. The cutoff value to diagnose diabetes with the presence of diabetic retinopathy was 6.75%. Conclusions: Our study showed a difference between the HbA1c values for diagnosing diabetes and the new diagnostic criterion from the ADA. Considering that the HbA1c characteristics may be influenced by race or culture, larger studies on diabetes complications are needed to identify the appropriate HbA1c value for Korean diabetics.
Keywords
Diabetes mellitus; Diagnosis; Glycated hemoglobin;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Yoon KH, Ko SH, Cho JH, Lee JM, Ahn YB, Song KH, Yoo SJ, Kang MI, Cha BY, Lee KW, Son HY, Kang SK, Kim HS, Lee IK, Bonner-Weir S. Selective beta-cell loss and alpha-cell expansion in patients with type 2 diabetes mellitus in Korea. J Clin Endocrinol Metab 88:2300-2308, 2003   DOI   ScienceOn
2 Wang WQ, Ip TP, Lam KS. Changing prevalence of retinopathy in newly diagnosed non-insulin dependent diabetes mellitus patients in Hong Kong. Diabetes Res Clin Pract 39:185-191, 1998   DOI   ScienceOn
3 Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393-403, 2002   DOI   ScienceOn
4 Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, Hu ZX, Lin J, Xiao JZ, Cao HB, Liu PA, Jiang XG, Jiang YY, Wang JP, Zheng H, Zhang H, Bennett PH, Howard BV. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and diabetes study. Diabetes Care 20:537-544, 1997   DOI   ScienceOn
5 Bennett CM, Guo M, Dharmage SC. HbA(1c) as a screening tool for detection of Type 2 diabetes: a systemic review. Diabet Med 24:333-343, 2007   DOI   ScienceOn
6 Harris MI. Impaired glucose tolerance in the U.S. population. Diabetes Care 12:464-474, 1989   DOI   ScienceOn
7 Ministry of Health and Welfare: 보건복지가족통계연보 2009. Avail from: http://www.mw.go.kr/front/jb/sjb0501vw.jsp?PAR_MENU_ID=03&MENU_ID=030501&page=4&BOARD_ID=320&BOARD_FLAG=&CONT_SEQ=224933&SEARCHKEY=&SEARCHVALUE=&SCH_SILKUK_ID=&SCH_DEPT_ID=
8 Alvin CP. Diabetes Mellitus. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Dan L, Longo J, Jameson L, Loscalzo J, eds. Harrison's principles of internal medicine. 17th ed. p. 2275-2304, New York, McGraw-Hill companies, 2008
9 Kahn SE. Clinical review 135: the importance of beta-cell failure in the development and progression of type 2 diabetes. J Clin Endocrinol Metab 86:4047-4058, 2001   DOI   ScienceOn
10 Harris MI, Klein R, Cowie CC, Rowland M, Byrd-Holt DD. Is the risk of diabetic retinopathy greater in non-Hispanic blacks and Mexican Americans than in non-hispanic whites with type 2 diabetes?: a U.S. population study. Diabetes Care 21:1230-1235, 1998   DOI   ScienceOn
11 Rajala U, Laakso M, Qiao Q, Keinanen-Kiukaanniemi S. Prevalence of retinopathy in people with diabetes, impaired glucose tolerance, and normal glucose tolerance. Diabetes Care 21:1664-1669, 1998   DOI   ScienceOn
12 Ministry of Health and Welfare: 국민건강통계 2008. Avail from: http://www.e-welfare.go.kr/wp/data/sta/view-Sta02Info.laf?content_id=208813&rn=35&path=/wfisc/wp/inf/sta/02/html&findword=&sub_class1=&search_div=¤tPage=31&search1=
13 Davidson MB, Schriger DL. Effect of age and race/ethnicity on HbA1c levels in people without known diabetes mellitus: implications for the diagnosis of diabetes. Diabetes Res Clin Pract 87:415-421, 2010   DOI   ScienceOn
14 배지철, 박철영, 오기원, 박성우, 김지훈, 이원영, 김선우, 최은숙, 이은정, 김원준, 박세은, 유승현. 서울의 한 대학병원에서 당뇨병을 예측하는 당화혈색소 값의 분석. Korean Diabetes J 33:503-510, 2009   DOI   ScienceOn
15 Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey 2005-2006. Avail from: http://www.cdc.gov/nchs/nhanes/nhanes2005-2006/nhanes05_06.htm
16 McCarter RJ, Hempe JM, Chalew SA. Mean blood glucose and biological variation have greater influence on HbA1c levels than glucose instability: an analysis of data from the diabetes control and complications trial. Diabetes Care 29:352-355, 2006   DOI   ScienceOn
17 Herman WH, Ma Y, Uwaifo G, Haffner S, Kahn SE, Horton ES, Lachin JM, Montez MG, Brenneman T, Barrett-Connor E. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care 30:2453-2457, 2007   DOI   ScienceOn
18 Little RR, Rohlfing CL, Wiedmeyer HM, Myers GL, Sacks DB, Goldstein DE. The national glycohemoglobin standardization program: a five year progress report. Clin Chem 47:1985-1992, 2001
19 Buell C, Kermah D, Davidson MB. Utility of A1C for diabetes screening in the 1999-2004 NHANES population. Diabetes Care 30:2233-2235, 2007   DOI   ScienceOn
20 World health Oragnization. Screening for type 2 diabetes: report of a WHO and international diabetes federation meeting. Geneva, World Health Organization, 2003
21 Likhari T, Gama R. Glycaemia-independent ethnic differences in HbA(1c) in subjects with impaired glucose tolerance. Diabet Med 26:1068-1069, 2009   DOI   ScienceOn
22 World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation: part 1. diagnosis and classification of diabetes mellitus. Geneva, World health Organization, 1999
23 Stratton IM, Adler AI, Neil HA, MatthewsDR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321:405-412, 2000   DOI   ScienceOn
24 Herman WH, Ma Y, Uwaifo G, Haffner S, Kahn SE, Horton ES, Lachin JM, Montez MG, Brenneman T, Barrett-Connor E. Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care 30:2453-2457, 2007   DOI   ScienceOn
25 Van Leiden HA, Dekker JM, Moll AC, Nijpels G, Heine RJ, Bouter LM, Stehouwer CD, Polak BC. Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study. Arch Ophthalmol 121:245-251, 2003   DOI   ScienceOn
26 Tapp RJ, Tikellis G, Wong TY, Harper CA, Zimmet PZ, Shaw JE. Longitudinal association of glucose metabolism with retinopathy: result from the Australian diabetes obesity and lifestyle (AusDiab) study. Diabetes Care 31:1349-1354, 2008   DOI   ScienceOn
27 DCCT Research Group. The association between glycemic exposure and longterm diabetes complications in the Diabetes Control and Complications Trial. Diabetes 44:968-983, 1995   DOI   ScienceOn
28 Pauker SG. Deciding about screening. Ann Intern Med 118:901-902, 1993   DOI   ScienceOn
29 Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 20:1183-1197, 1997   DOI
30 American diabetes association. Diagnosis and classification of diabetes mellitus. Diabetes Care 33(Suppl 1):S62-S69, 2010   DOI
31 Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343-1350, 2001   DOI   ScienceOn
32 Ballard DJ, Humphrey LL, Melton LJ 3rd, Frohnert PP, Chu PC, O'Fallon WM, Palumbo PJ. Epidemiology of persistent proteinuria in type II diabetes mellitus: population-based study in Rochester, Minnesota. Diabetes 37:405-412, 1988   DOI   ScienceOn
33 Kohner EM, Aldington SJ, Stratton IM, Manley SE, Holman RR, Matthews DR, Turner RC. United Kingdom prospective diabetes study, 30: diabetic retinopathy at diagnosis of non-insulin-dependent diabetes mellitus and associated risk factors. Arch Ophthalmol 116:297-303, 1998   DOI
34 Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care 15:815-819, 1992   DOI   ScienceOn