Diagnosis of diabetes: HbA<inf>1c</inf>versus WHO criteria
Manley S., Nightingale P., Stratton I., Sikaris K., Smith J., Cramb R., Gough S.
The authors compared the diagnosis of type 2 diabetes using an HbA1ccut-off point of ≥6.5% (≥48 mmol/mol) with current World Health Organization (WHO) criteria involving fasting plasma glucose and an oral glucose tolerance test. Diabetes was confirmed in 35% of Australian and 49% of UK participants using WHO criteria and a similar prevalence was obtained using HbA1c- 31% and 46%, respectively. Using HbA1clevels alone for diagnosis does not define the same people with diabetes as the WHO criteria. A considerable number of participants (38% of Australian and 49% of British) diagnosed with diabetes by WHO criteria would not have been diagnosed using a single HbA1ctest. More consideration of the use of HbA1cas a screening test for diabetes is required.