Comparative study of HbA 1c and fasting plasma glucose vs the oral glucose tolerance test for diagnosis of diabetes in people with tuberculosis.

Autor: Aftab H; Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Ambreen A; Gulab Devi Chest Hospital, Lahore, Pakistan., Jamil M; Gulab Devi Chest Hospital, Lahore, Pakistan., Garred P; Laboratory of Molecular Medicine, Department of Clinical Immunology, University of Copenhagen, Copenhagen, Denmark., Petersen JH; Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Nielsen SD; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark., Bygbjerg IC; Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Christensen DL; Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2017 Jun; Vol. 34 (6), pp. 800-803. Date of Electronic Publication: 2017 Apr 11.
DOI: 10.1111/dme.13354
Abstrakt: Aim: To compare HbA 1c and fasting plasma glucose assessment, with the 2-h oral glucose tolerance test as reference, in screening for diabetes in people with turberculosis.
Methods: Individuals (N=268) with newly diagnosed smear-positive tuberculosis were screened for diabetes at a tertiary hospital in Lahore, Pakistan. Diabetes diagnosis was based on WHO criteria: thresholds were ≥48 mmol/mol (≥6.5%) for HbA 1c and ≥7.0mmol/l for fasting plasma glucose.
Results: The proportion of participants diagnosed with diabetes was 4.9% (n =13) by oral glucose tolerance test, while 11.9% (n =32) and 14.6% (n =39) were diagnosed with diabetes using HbA 1c and fasting plasma glucose criteria, respectively. The area under the receiver-operating characteristic curve was 0.79 (95% CI 0.64 to 0.94) for HbA 1c and 0.61 (95% CI 0.50 to 0.73) for fasting plasma glucose, with a borderline significant difference between the two tests (P=0.07).
Conclusions: HbA 1c and fasting plasma glucose performed equally in terms of diagnosing new diabetes cases in individuals with tuberculosis, but the proportion of participants falsely classified as positive was higher for fasting plasma glucose. This may be explained by acute blood glucose fluctuations when using fasting plasma glucose. HbA 1c may be a more reliable test in individuals with transient hyperglycaemia.
(© 2017 Diabetes UK.)
Databáze: MEDLINE
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