Christensen D.L., Witte D.R., Kaduka L., Jørgensen M.E., Borch-Johnsen K., Mohan V., Shaw J.E., Tab́ak A.G., Vistisen D.
Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark; Centre for Public Health Research, KEMRI, Nairobi, Kenya; Centre for Health Research in Greenland, Directorate of Health and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Research Centre for Prevention and Health, Glostrup Hospital, Copenhagen, Denmark; Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Noncommunicable Diseases Prevention and Control, Chennai, India; Baker IDI Heart and Diabetes Institute, Caulfield, VIC, Australia; Department of Epidemiology and Public Health, University College London, London, United Kingdom; 1st Department of Internal Medicine, Semmelweis University, Faculty of Medicine, Budapest, Hungary
Christensen, D.L., Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark, Steno Diabetes Center, Gentofte, Denmark; Witte, D.R., Steno Diabetes Center, Gentofte, Denmark; Kaduka, L., Centre for Public Health Research, KEMRI, Nairobi, Kenya; Jørgensen, M.E., Centre for Health Research in Greenland, Directorate of Health and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Borch-Johnsen, K., Steno Diabetes Center, Gentofte, Denmark, Research Centre for Prevention and Health, Glostrup Hospital, Copenhagen, Denmark; Mohan, V., Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Noncommunicable Diseases Prevention and Control, Chennai, India; Shaw, J.E., Baker IDI Heart and Diabetes Institute, Caulfield, VIC, Australia; Tab́ak, A.G., Department of Epidemiology and Public Health, University College London, London, United Kingdom, 1st Department of Internal Medicine, Semmelweis University, Faculty of Medicine, Budapest, Hungary; Vistisen, D., Steno Diabetes Center, Gentofte, Denmark
OBJECTIVE - To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. RESEARCH DESIGN AND METHODS - Six studies (1999-2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C ≥6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. RESULTS - Diabetes prevalence was lower with the A1C-based diagnostic criteria in four of six studies. The probability of an A1C ≥6.5% among OGTT-diagnosed case subjects ranged widely (17.0-78.0%) by study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. study were of the same magnitude as between-country comparisons. CONCLUSIONS - A shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations. © 2010 by the American Diabetes Association.