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HbA1c as a screening tool for detection of type 2 diabetes: A systematic review Bennett, C.M., Gao, M. and Dharmage, S.C. 2007, HbA1c as a screening tool for detection of type 2 diabetes: A systematic review, Diabetic medicine, vol. 24, no. 4, pp. 333-343. Title HbA1c as a screening tool for detection of type 2 diabetes: A systematic review Author(s) Bennett, C.M. Gao, M. Dharmage, S.C. Journal name Diabetic medicine Volume number 24 Issue number 4 Start page 333 End page 343 Publisher Wiley - Blackwell Publishing Place of publication Oxford, England Publication date 2007-04 ISSN 0742-3071 1464-5491 1466-5468 Keyword(s) diabetes diagnosis screening HbA1c systematic review Summary Aim: To assess the validity of glycated haemoglobin A1c (HbA1c) as a screening tool for early detection of Type 2 diabetes. Methods: Systematic review of primary cross-sectional studies of the accuracy of HbA1c for the detection of Type 2 diabetes using the oral glucose tolerance test as the reference standard and fasting plasma glucose as a comparison. Results: Nine studies met the inclusion criteria. At certain cut-off points, HbA1c has slightly lower sensitivity than fasting plasma glucose (FPG) in detecting diabetes, but slightly higher specificity. For HbA1c at a Diabetes Control and Complications Trial and UK Prospective Diabetes Study comparable cut-off point of ≥ 6.1%, the sensitivity ranged from 78 to 81% and specificity 79 to 84%. For FPG at a cut-off point of ≥ 6.1 mmol/l, the sensitivity ranged from 48 to 64% and specificity from 94 to 98%. Both HbA1c and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). Conclusions: HbA1c and FPG are equally effective screening tools for the detection of Type 2 diabetes. The HbA1c cut-off point of > 6.1% was the recommended optimum cut-off point for HbA1c in most reviewed studies; however, there is an argument for population-specific cut-off points as optimum cut-offs vary by ethnic group, age, gender and population prevalence of diabetes. Previous studies have demonstrated that HbA1c has less intra-individual variation and better predicts both micro- and macrovascular complications. Although the current cost of HbA1c is higher than FPG, the additional benefits in predicting costly preventable clinical complications may make this a cost-effective choice. Language eng Field of Research 110399 Clinical Sciences not elsewhere classified HERDC Research category C1.1 Refereed article in a scholarly journal Copyright notice ©2007, The Authors Persistent URL http://hdl.handle.net/10536/DRO/DU:30021869 Document type: Journal Article Collections: School of Health and Social Development Higher Education Research Group Related Links Link Description Connect to published version (restricted access) Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Mon, 18 Jan 2010, 11:01:05 EST Thu, 28 Jan 2010, 14:27:19 EST Thu, 28 Jan 2010, 14:29:08 EST Filtered Full Citation counts:   Cited 152 times in TR Web of Science Cited 181 times in Scopus Search Google Scholar Access Statistics: 496 Abstract Views  -  Detailed Statistics Created: Mon, 18 Jan 2010, 11:01:05 EST

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