Performance of HbA1c and Fasting Plasma Glucose in Screening for Diabetes in Patients Undergoing Coronary Angiography

Author:

Wang Jun-Sing12,Lee I-Te134,Lee Wen-Jane5,Lin Shih-Yi13,Fu Chia-Po1,Ting Chih-Tai36,Lee Wen-Lieng36,Liang Kae-Woei346,Sheu Wayne Huey-Herng137

Affiliation:

1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

2. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

3. Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

4. Department of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan

5. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan

6. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan

7. Institute of Medical Technology, College of Life Sciences, National Chung-Hsing University, Taichung, Taiwan

Abstract

OBJECTIVE The performance of glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) was compared in screening for diabetes by an oral glucose tolerance test (OGTT) in patients undergoing coronary angiography (CAG). RESEARCH DESIGN AND METHODS Patients without known diabetes admitted for CAG were eligible. OGTT and HbA1c were assessed 2–4 weeks after hospital discharge. The performance of HbA1c and FPG was evaluated by using receiver operating characteristic (ROC) analysis. RESULTS Diabetes was diagnosed in 83 of 400 patients (20.8%). The area under the ROC curve was higher for FPG than for HbA1c (0.81 vs. 0.73, P = 0.032). We proposed a screening algorithm and validated it in another 170 patients. Overall, this algorithm reduced the number of OGTTs by 71.4% (sensitivity 74.4%, specificity 100%). CONCLUSIONS FPG performed better than HbA1c in screening for diabetes in patients undergoing CAG. A screening algorithm might help to reduce the number of OGTTs.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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