Performance of HbA1c and Fasting Plasma Glucose in Screening for Diabetes in Patients Undergoing Coronary Angiography

  1. Wayne Huey-Herng Sheu, MD, PHD1,3,7
  1. 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
  2. 2Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  3. 3Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  4. 4Department of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  5. 5Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
  6. 6Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
  7. 7Institute of Medical Technology, College of Life Sciences, National Chung-Hsing University, Taichung, Taiwan
  1. Corresponding author: Wayne Huey-Herng Sheu, whhsheu{at}vghtc.gov.tw.

Abstract

OBJECTIVE The performance of glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) was compared in screening for diabetes by an oral glucose tolerance test (OGTT) in patients undergoing coronary angiography (CAG).

RESEARCH DESIGN AND METHODS Patients without known diabetes admitted for CAG were eligible. OGTT and HbA1c were assessed 2–4 weeks after hospital discharge. The performance of HbA1c and FPG was evaluated by using receiver operating characteristic (ROC) analysis.

RESULTS Diabetes was diagnosed in 83 of 400 patients (20.8%). The area under the ROC curve was higher for FPG than for HbA1c (0.81 vs. 0.73, P = 0.032). We proposed a screening algorithm and validated it in another 170 patients. Overall, this algorithm reduced the number of OGTTs by 71.4% (sensitivity 74.4%, specificity 100%).

CONCLUSIONS FPG performed better than HbA1c in screening for diabetes in patients undergoing CAG. A screening algorithm might help to reduce the number of OGTTs.

  • Received July 19, 2012.
  • Accepted October 14, 2012.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

This Article

  1. Diabetes Care
  1. Supplementary Data
  2. All Versions of this Article:
    1. dc12-1434v1
    2. 36/5/1138 most recent