Comparison of A1C and Fasting Glucose Criteria to Diagnose Diabetes Among U.S. Adults
- April P. Carson, PHD1,
- Kristi Reynolds, PHD2,
- Vivian A. Fonseca, MD3 and
- Paul Muntner, PHD1
- 1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama;
- 2Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California;
- 3Scott and White Clinic, Texas A&M Health Sciences Center, Temple, Texas.
- Corresponding author: April P. Carson, apcarson{at}uab.edu.
Abstract
OBJECTIVE To compare A1C and fasting glucose for the diagnosis of diabetes among U.S. adults.
RESEARCH DESIGN AND METHODS This study included 6,890 adults (≥20 years of age) from the 1999–2006 National Health and Nutrition Examination Survey without a self-reported history of diabetes who had fasted ≥9 h. A1C ≥6.5% and fasting glucose ≥126 mg/dl were used, separately, to define diabetes.
RESULTS Overall, 1.8% of U.S. adults had A1C ≥6.5% and fasting glucose ≥126 mg/dl, 0.5% had A1C ≥6.5% and fasting glucose <126 mg/dl, and 1.8% had A1C <6.5% and fasting glucose ≥126 mg/dl. Compared with individuals with A1C <6.5% and fasting glucose ≥126 mg/dl, individuals with A1C ≥6.5% and fasting glucose <126 mg/dl were younger, more likely to be non-Hispanic black, had lower Hb levels, and had higher C-reactive protein.
CONCLUSIONS A1C ≥6.5% demonstrates reasonable agreement with fasting glucose for diagnosing diabetes among U.S. adults.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received July 6, 2009.
- Accepted September 21, 2009.
- © 2010 by the American Diabetes Association.
