Diabetes Care, Vol 21, Issue 10 1686-1690, Copyright © 1998 by American Diabetes Association

ARTICLES

The 1997 American Diabetes Association criteria versus the 1985 World Health Organization criteria for the diagnosis of abnormal glucose tolerance: poor agreement in the Hoorn Study

F de Vegt, JM Dekker, CD Stehouwer, G Nijpels, LM Bouter and RJ Heine
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands. f.de_vegt.emgo@med.vu.nl

OBJECTIVE: Recently, the American Diabetes Association (ADA) introduced new diagnostic criteria. These new criteria are based on fasting plasma glucose levels, avoiding the burdensome oral glucose tolerance test (OGTT). We compared the 1997 ADA criteria with the 1985 World Health Organization (WHO) criteria with respect to the prevalence of diabetes and the cardiovascular risk profile in the population of the Hoorn Study RESEARCH DESIGN AND METHODS: The Hoorn Study is a population-based survey of 2,484 men and women, aged 50-75 years. An OGTT was performed and cardiovascular risk factors were determined in 2,378 subjects without known diabetes. Subjects were categorized according to both sets of diagnostic criteria. RESULTS: Although the prevalence of diabetes was similar for both sets of criteria, 47 of 120 (39.2%) subjects who were diagnosed with diabetes according to the 1997 ADA criteria were not classified as having diabetes when using the 1985 WHO criteria. Similarly, of 285 subjects diagnosed with impaired fasting glucose by the 1997 ADA criteria, 195 (68.4%) were classified as having normal glucose tolerance by the 1985 WHO criteria. The overall agreement was poor (kappa 0.33; 95% CI 0.28-0.38). Subjects who were diagnosed as having diabetes by either set of criteria had an adverse cardiovascular risk profile, which was between the cardiovascular risk profiles of concordant normal and concordant diabetic subjects. CONCLUSIONS: In this study both sets of criteria diagnosed a similar number of diabetic subjects, but many of the subjects shifted between glucose intolerance categories. With either set of criteria, a considerable number of subjects at risk of developing diabetes and subjects carrying an increased risk of cardiovascular disease, as reflected by an adverse cardiovascular risk profile, will be missed.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. A. Abdul-Ghani, M. Matsuda, R. Jani, C. P. Jenkinson, D. K. Coletta, K. Kaku, and R. A. DeFronzo The relationship between fasting hyperglycemia and insulin secretion in subjects with normal or impaired glucose tolerance Am J Physiol Endocrinol Metab, August 1, 2008; 295(2): E401 - E406. [Abstract] [Full Text] [PDF]

				M. A. C. J. Gelens, M. H. L. Christiaans, and J. P. van Hooff Glucose metabolism before and after conversion from cyclosporine microemulsion to tacrolimus in stable renal recipients Nephrol. Dial. Transplant., February 1, 2008; 23(2): 701 - 706. [Abstract] [Full Text] [PDF]

				C. S.V. Oliveira, J. G. H. Vieira, M. T. Ghiringhello, O. M. Hauache, C. H. M. Oliveira, C. Khawali, C. Ferrer, T. T. Tachibana, R. M.B. Maciel, G. Velho, et al. Diagnosis of Hyperglycemia in a Cohort of Brazilian Subjects: Fasting plasma glucose and oral glucose tolerance test based glycemic status are associated with different profiles of insulin sensitivity and insulin secretion Diabetes Care, August 1, 2007; 30(8): 2135 - 2137. [Full Text] [PDF]

				R. P. Donahue, S. Stranges, K. Rejman, L. B. Rafalson, J. Dmochowski, and M. Trevisan Elevated Cystatin C Concentration and Progression to Pre-Diabetes: The Western New York Study Diabetes Care, July 1, 2007; 30(7): 1724 - 1729. [Abstract] [Full Text] [PDF]

				R. P. Donahue, K. Rejman, L. B. Rafalson, J. Dmochowski, S. Stranges, and M. Trevisan Sex Differences in Endothelial Function Markers Before Conversion to Pre-Diabetes: Does the Clock Start Ticking Earlier Among Women?: The Western New York Study Diabetes Care, February 1, 2007; 30(2): 354 - 359. [Abstract] [Full Text] [PDF]

				M. A. Abdul-Ghani, K. Williams, R. DeFronzo, and M. Stern Risk of Progression to Type 2 Diabetes Based on Relationship Between Postload Plasma Glucose and Fasting Plasma Glucose Diabetes Care, July 1, 2006; 29(7): 1613 - 1618. [Abstract] [Full Text] [PDF]

				M. A. Abdul-Ghani, C. P. Jenkinson, D. K. Richardson, D. Tripathy, and R. A. DeFronzo Insulin secretion and action in subjects with impaired fasting glucose and impaired glucose tolerance: results from the veterans administration genetic epidemiology study. Diabetes, May 1, 2006; 55(5): 1430 - 1435. [Abstract] [Full Text] [PDF]

				R. Gomez-Diaz, C. A. Aguilar-Salinas, S. Moran-Villota, R. Barradas-Gonzalez, R. Herrera-Marquez, M. Cruz Lopez, J. Kumate, and N. H. Wacher Lack of Agreement Between the Revised Criteria of Impaired Fasting Glucose and Impaired Glucose Tolerance in Children With Excess Body Weight Diabetes Care, September 1, 2004; 27(9): 2229 - 2233. [Abstract] [Full Text] [PDF]

				M. Hanefeld, J. L. Chiasson, C. Koehler, E. Henkel, F. Schaper, and T. Temelkova-Kurktschiev Acarbose Slows Progression of Intima-Media Thickness of the Carotid Arteries in Subjects With Impaired Glucose Tolerance Stroke, May 1, 2004; 35(5): 1073 - 1078. [Abstract] [Full Text] [PDF]

				A. M.W. Spijkerman, M. F. Yuyun, S. J. Griffin, J. M. Dekker, G. Nijpels, and N. J. Wareham The Performance of a Risk Score as a Screening Test for Undiagnosed Hyperglycemia in Ethnic Minority Groups: Data from the 1999 Health Survey for England Diabetes Care, January 1, 2004; 27(1): 116 - 122. [Abstract] [Full Text] [PDF]

				I. Mogren, B. Lindahl, and U. Hogberg Impaired fasting glucose and impaired glucose tolerance are related to both heredity and low birth weight Scand J Public Health, October 1, 2003; 31(5): 382 - 388. [Abstract] [PDF]

				R G. Barr, D. M. Nathan, J. B. Meigs, and D. E. Singer Tests of Glycemia for the Diagnosis of Type 2 Diabetes Mellitus Ann Intern Med, August 20, 2002; 137(4): 263 - 272. [Abstract] [Full Text] [PDF]

				E. Eschwege, M. A. Charles, D. Simon, N. Thibult, and B. Balkau Reproducibility of the Diagnosis of Diabetes Over a 30-Month Follow-Up: The Paris Prospective Study Diabetes Care, November 1, 2001; 24(11): 1941 - 1944. [Abstract] [Full Text] [PDF]

				T. P. Erlinger and F. L. Brancati Postchallenge Hyperglycemia in a National Sample of U.S. Adults With Type 2 Diabetes Diabetes Care, October 1, 2001; 24(10): 1734 - 1738. [Abstract] [Full Text] [PDF]

				R. C. Perry, R. R. Shankar, N. Fineberg, J. McGill, and A. D. Baron HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose: The Early Diabetes Intervention Program (EDIP) Diabetes Care, March 1, 2001; 24(3): 465 - 471. [Abstract] [Full Text]

				D. Liao, J. B. Shofer, E. J. Boyko, M. J. McNeely, D. L. Leonetti, S. E. Kahn, and W. Y. Fujimoto Abnormal Glucose Tolerance and Increased Risk for Cardiovascular Disease in Japanese-Americans With Normal Fasting Glucose Diabetes Care, January 1, 2001; 24(1): 39 - 44. [Abstract] [Full Text]

				A. von Eckardstein, H. Schulte, and G. Assmann Risk for Diabetes Mellitus in Middle-Aged Caucasian Male Participants of the PROCAM Study: Implications for the Definition of Impaired Fasting Glucose by the American Diabetes Association J. Clin. Endocrinol. Metab., September 1, 2000; 85(9): 3101 - 3108. [Abstract] [Full Text]