Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus in a Semi-Urban Brazilian Population

Nayla Cristina do Vale Moreira, Renan M. Montenegro, Haakon E. Meyer, Bishwajit Bhowmik, Ibrahimu Mdala, Tasnima Siddiquee, Virgínia Oliveira Fernandes and Akhtar Hussain
Additional contact information
Nayla Cristina do Vale Moreira: Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo (UiO), Oslo 0318, Norway
Renan M. Montenegro: Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza-Ceará 60020-181, Brazil
Haakon E. Meyer: Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo (UiO), Oslo 0318, Norway
Bishwajit Bhowmik: Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo (UiO), Oslo 0318, Norway
Ibrahimu Mdala: Institute of Health and Society, Department of General Practice, University of Oslo (UiO), Oslo 0318, Norway
Tasnima Siddiquee: Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh
Virgínia Oliveira Fernandes: Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza-Ceará 60020-181, Brazil
Akhtar Hussain: Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Fortaleza-Ceará 60020-181, Brazil

IJERPH, 2019, vol. 16, issue 19, 1-15

Abstract: The study evaluated glycated hemoglobin (HbA1c) as a diagnostic tool for diabetes and pre-diabetes in the Brazilian population. Further, the homeostasis model assessment of insulin resistance (HOMA-IR) was also examined against HbA1c values to identify the most suitable cut-off points for HOMA-IR to predict the risk of diabetes. A cross-sectional study was conducted among 714 randomly selected subjects. HbA1c, fasting, and 2 h plasma glucose values were measured. Insulin resistance estimates were calculated with HOMA-IR. The receiver operating characteristic curve assessed HbA1c performance. The adjusted prevalence rate of diabetes mellitus was 14.7%, and pre-diabetes 14.2%. The optimal HbA1c cut-off value was ≥6.8% for the diagnosis of diabetes, and ≥6.0% for pre-diabetes. The area under the curve using HbA1c was 0.85 (95% CI: 0.80–0.90) for detecting diabetes and 0.61 (95% CI: 0.55–0.67) for pre-diabetes. The optimal HOMA-IR cut-off value was 2.06 for HbA1c at 6.8%. The HbA1c cut-off value of ≥6.8% may be suitable for diagnosing diabetes in the Brazilian population. Our results do not support the use of HbA1c to diagnose pre-diabetes. A HOMA-IR cut-off point of 2.06 was a sensitive marker to assess the risk of diabetes.

Keywords: diabetes mellitus; glycated hemoglobin; diagnosis; insulin resistance; Brazil (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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