A systematic review on HbA1c as a screening tool for detection of type 2 diabetes
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A systematic literature review was performed to assess the accuracy of glycated haemoglobin A1c for the detection of type 2 diabetes using as the following inclusion criteria: (i) an oral glucose tolerance test as the reference standard, and (ii) fasting blood glucose (FBG) as a comparison. Among the 9 studies meeting these inclusion criteria, HbA1c and FBG were equally effective in detecting type 2 diabetes. In most studies, the recommended optimum cut-off point for HbA1c was >6.1%, though population-specific optimum cut-off points may be warranted. However, as previous studies have shown HbA1c to exhibit less intra-individual variation and better prediction of micro- and macrovascular complications, HbA1c, despite its higher cost than FPG, may be a more cost-effective means of screening for type 2 diabetes once cost-effectiveness of predicting preventable complications is taken into account.
Abstract
