Effect of HbA1c combined FPG on screening diabetes in health checkup

Objective:To appraise the effectiveness of HbA1cand fasting plasma glucose(FPG) on screening diabetes in health check-up.Methods:A total of 1 337 individuals(male 850,female 487),aged 27 to 91 years with HbA1ctest were included.Participates with HbA1c≥6.0%or FPG≥6.1 mmol/ L underwent oral glucose tolerance test(OGTT).Diabetes mellitus was diagnosed according to the criteria of WHO in 1999,FPG≥7.0 mmol/L and/or OGTT 2 h-postload plasm glucose(2 h-PG)≥11.1 mmol/L.The sensitivity and specificity of HbA1cthresholds and FPG or combination test on screening of diabetes were analyzed.Results:A total of 842 subjects had HbA1c<6.0%,in which 32 had isolated FPG≥6.1 mmol/L,of 495 had HbA1c≥6.0%.Subjects with HbA1c≥6.0% had significant increased disorder indexes than those with HbA1c<6.0%.527 subjects who had HbA1c≥6.0%or FPG≥6.1 mmol/L underwent OGTT.A total of 234 subjects were newly diagnosed diabetes,including 123(123/234,52.56%) with FPG≥7.0 mmol/L,and 111 subjects(111/234, 47.43%) with isolated 2 h-PG≥11.1 mmol/L.Among 234 new diabetes,91.88%(215 subjects) had HbA1c≥6.3%,and 77.40%(181 subjects) had HbA1c≥6.5%.HbA1c≥6.3%combined FPG≥7.0 mmol/L increased the positive rate of newly diagnosed diabetes from 91.88%to 96.58%. Conclusions:HbA1cis a practical and convenient tool for screening undiagnosed diabetes in routine health check-up of a large population.Combined use of HbA1c≥6.3%and/or FPG≥7.0 mmol/L is efficient for early detection of diabetes.