An additional measurement of glycated albumin can help prevent missed diagnosis of diabetes in Chinese population

Abstract

BackgroundIn subjects who present a first fasting plasma glucose (FPG1) ≥7.0mmol/l without classic symptoms of diabetes, diagnosis of diabetes will likely be missed without an additional oral glucose tolerance test (OGTT) in the Chinese population. Recent studies have shown that glycated albumin (GA) has advantages in reflecting postprandial hyperglycemia. Therefore, the present study evaluated whether additional measurement of GA could reduce the rate of missed diagnosis of diabetes. MethodsA total of 1287 participants (711 men, 576 women) with a FPG1≥7.0mmol/l without classic symptoms of diabetes were enrolled and underwent a 75-g OGTT. Serum GA was measured by a liquid enzyme method. Diabetes was diagnosed based on the 2010 American Diabetes Association (ADA) criteria. ResultsA total of 992 (77.08%) participants were diagnosed diabetes by OGTT and glycated hemoglobin A1c (HbA1c). The diagnostic validity of 2-h postload plasma glucose (2hPG) was superior to other glycemic index (the diagnostic sensitivity of 2hPG, HbA1c, the second FPG (FPG2) was 87.50%, 73.99%, 63.21%, respectively). Without 2hPG after OGTT, repeat testing of FPG2 alone would result in missed diagnosis of 36.79% of diabetic participants, whereas testing FPG2 with HbA1c was associated with a missed diagnosis rate of 14.31%. While using the combined criteria of FPG2≥7.0mmol/l and/or HbA1c≥6.5% and/or GA≥17.1%, the rate of missed diagnosis was merely 9.48%. That is, the rate of missed diagnosis was reduced by 33.75% with the addition of GA measurement. The k value reflecting the consistency of diagnosis between the FPG2 and/or HbA1c and/or GA criteria and the 2010 ADA criteria was 0.788. ConclusionsFor subjects with FPG1 ≥7.0mmol/l without classic symptoms of diabetes, additional measurement of GA can help prevent missed diagnosis of diabetes in Chinese population.