Use of Hemoglobin A1C to Diagnose Diabetes Essay

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USE OF HEMOGLOBIN A1C TO DIAGNOSE DIABETES Introduction In 2009 the International Expert Committee, which consisted of experts from the American Diabetes Association (ADA), the European Association for the Study of Diabetes, and the International Diabetes Federation, released a report that recommended the use of Hemoglobin A1c (HbA1c) to diagnose diabetes (American Diabetes Association [ADA], 2013; International Expert Committee, 2009). HbA1c is a widely used marker of chronic glycemia, because it reflects an individual’s average blood glucose levels over a 2-3 month time period (ADA, 2013). Also, HbA1c is largely used as the standard biomarker for the adequacy of individuals’ glycemic management (ADA, 2013; Bao et al., 2010). The…show more content…
In a study done by Lee et al. (2011) the HbA1c threshold of 6.5% was used for detecting diabetes, and it resulted in a higher point estimate for sensitivity for adolescents compared with adults, 75% and 53.8% respectively. Using recommended HbA1c thresholds of ≥ 5.7% or ≥ 6.0% for predicting pre-diabetes in adolescents had poor sensitivity and was a poor marker for detecting pre-diabetes in adolescents compared with adults, whether diagnosed with FPG or 2-hr PG (Lee et al., 2011). However, among older adult participants (69.4 ± 11.1 years old) in the study by Kramer et al. (2010) there was a low sensitivity and specificity for diagnosing diabetes, specifically type 2 diabetes, at a HbA1c threshold of 6.5%. Similarly, in the study conducted by Nowicka et al. (2011) HbA1c of 6.5% had relatively low sensitivity and specificity for classifying type 2 diabetes. Also, there was poor agreement between HbA1c and oral glucose tolerance test criteria in classifying patients with glucose values suggestive of type 2 diabetes (Nowicka et al., 2011). Vehik et al. (2012) found in participants < 21 years of age that the current HbA1c threshold of 6.5% is not a sensitive indicator for diagnosing type 1 diabetes in individuals already diagnosed with type 1 diabetes by an oral glucose tolerance test. Additionally,
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