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RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
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VOLUME 16 NUMBER 1 • JULY 2019
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HbA
1c
test ‘highly unreliable’ at diagnosing diabetes
T
he haemoglobin A
1c
blood test is ‘highly
unreliable’ at diagnosing diabetes and
tends to underestimate the prevalence
of the disease, according to a study
presented at ENDO 2019, the Endocrine
Society’s annual meeting in New Orleans.
‘Based on our findings, HbA
1c
should not
be solely used to determine the prevalence
of diabetes,’ said lead researcher Dr Maria
Mercedes Chang Villacreses, of City of
Hope’s Diabetes and Metabolism Research
Institute in Duarte, California. ‘It should be
used in conjunction with the oral glucose
test for increased accuracy.’
The HbA
1c
is a test that shows the
average level of blood sugar over the
past two to three months. People who
have diabetes usually have this test to
see whether their blood sugar levels
have been staying within a target range.
This test is also used to diagnose type 1
and type 2 diabetes. It is often used to
diagnose diabetes because no fasting or
any preparation is required.
A glucose tolerance test, also known as
the oral glucose tolerance test, measures
the body’s response to sugar (glucose). In
this test, a person’s blood is taken after
an overnight fast, and then again two
hours after they drink a sugary drink.
The glucose tolerance test can be used to
screen for type 2 diabetes.
The study included 9 000 adults without
a diabetes diagnosis. The participants got
both a HbA
1c
and an oral glucose tolerance
test, and the researchers compared the
results. The researchers found the HbA
1c
test didn’t catch 73% of diabetes cases
that were detected by the oral glucose
test. ‘The HbA
1c
test said these people had
normal glucose levels when they didn’t,’
Chang Villacreses said.
The researchers also found race and
ethnicity had a significant impact on the
accuracy of HbA
1c
. It was more likely to
detect abnormal glucose levels in non-
Hispanic whites than in non-Hispanic
blacks or Hispanics.
‘Our results indicated that the
prevalence of diabetes and normal glucose
tolerance defined solely by HbA
1c
is highly
unreliable, with a significant tendency
for underestimation of the prevalence of
diabetes and overestimation of normal
glucose tolerance,’ Chang Villacreses said.
Source: Medical Brief 2019