A1C to Detect Diabetes in Healthy Adults: When should we recheck?

OBJECTIVE: To evaluate the optimal interval for rechecking A1C levels below the diagnostic threshold of 6.5% for healthy adults. RESEARCH DESIGN AND METHODS: This was a retrospective cohort study. Participants were 16,313 apparently healthy Japanese adults not taking glucose-lowering medications at baseline. Annual A1C measures from 2005 to 2008 at the Center for Preventive Medicine, a community teaching hospital in Japan, estimated cumulative incidence of diabetes. RESULTS: Mean age (+/-SD) of participants was 49.7 +/- 12.3 years, and 53% were male. Mean A1C at baseline was 5.4 +/- 0.5%. At 3 years, for those with A1C at baseline of &lt;5.0%, 5.0-5.4%, 5.5-5.9%, and 6.0-6.4%, cumulative incidence (95% CI) was 0.05% (0.001-0.3), 0.05% (0.01-0.11), 1.2% (0.9-1.6), and 20% (18-23), respectively. CONCLUSIONS: In those with an A1C &lt;6.0%, rescreening at intervals shorter than 3 years identifies few individuals (approximately or=6.5%.</or=1%)

Random Capillary Blood Glucose Cut Points for Diabetes and Pre-Diabetes Derived From Community-Based Opportunistic Screening in India

OBJECTIVE: To determine random capillary blood glucose (RCBG) cut points that discriminate diabetic and pre-diabetic subjects from normal individuals. RESEARCH DESIGN AND METHODS: RCBG was performed in 1,333 individuals randomly chosen from 63,305 individuals who had participated in an opportunistic screening program. An oral glucose tolerance test was also performed by venous plasma glucose on an autoanalyzer. RCBG cut points that discriminate diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) were determined using receiver operating characteristic curves. RESULTS: Using 2-h plasma glucose >or=200 mg/dl (11.1 mmol/l) criterion, the RCBG cut point of 140 mg/dl (7.7 mmol/l) gave the highest sensitivity and specificity. For 2-h plasma glucose >or=200 mg/dl (11.1 mmol/l) and fasting plasma glucose (FPG) >or=126 mg/dl (7.0 mmol/l) criteria, either 2-h plasma glucose >or=200 mg/dl (11.1 mmol/l) or FPG >or=126 mg/dl (7.0 mmol/l) criterion, and the FPG >or=126 mg/dl (7.0 mmol/l) criterion, RCBG cut point was 143 mg/dl (7.9 mmol/l). RCBG cut points for IGT, IFG according to World Health Organization criterion, and IFG according to American Diabetes Association criterion were 119 mg/dl (6.6 mmol/l), 118 mg/dl (6.6 mmol/l), and 113 mg/dl (6.3 mmol/l), respectively. CONCLUSIONS: Asian Indians with RCBG >110 mg/dl at screening can be recommended to undergo definitive testing

Lower Serum Creatinine Is a New Risk Factor of Type 2 Diabetes: The Kansai Healthcare Study

OBJECTIVE—Because skeletal muscle is one of the target tissues for insulin, skeletal muscle mass might be associated with type 2 diabetes. Serum creatinine is a possible surrogate marker of skeletal muscle mass. The purpose of this study was to determine whether serum creatinine level is associated with type 2 diabetes

Diabetes and Other Disorders of Glycemia in a Rural South African Community: Prevalence and associated risk factors

OBJECTIVE—The purpose of this study was to determine the prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glycemia (IFG), and associated risk factors in a rural South African black community