Unknown Diabetes Could Be Identified with Biomarkers in Morbidly Obese Patients
Fasting glucose (FG) and glycated hemoglobin A1c (HbA1c) were both able to identify patients with morbid obesity and undiagnosed type 2 diabetes, according to a recent study.
The study included 537 patients with morbid obesity without a diabetes diagnosis. FG and HbA1c were used to assess the prevalence of diabetes among patients with obesity, and the performance between both measures was compared to determine which better identified those with undiagnosed diabetes.
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Overall, 49 patients (9%) had unknown diabetes, of whom 16 patients (33%) fulfilled the criteria for HbA1c and FG.
A total of 284 patients (53%) were identified with prediabetes, of whom 133 patients (47%) fulfilled the criteria for HbA1c and FG.
The measurements of agreement for FG and HbA1c were moderate for diabetes and fair for prediabetes. For identifying diabetes, the optimal threshold for FG was ≥ 6.6 mmol/L, and the optimal threshold for HbA1c was ≥ 6.1% (43 mmol/mol).
“The prevalence of [type 2 diabetes] remains high and both FG and HbA1c identify patients with unknown [type 2 diabetes]. FG was slightly superior to HbA1c in predicting and separating patients with unknown [type 2 diabetes] from patients without [type 2 diabetes],” the researchers concluded. “We suggest that an FG ≥ 6.6 mmol/L or an HbA1c ≥ 6.1% (43 mmol/mol) may be used as primary cut points for the identification of unknown [type 2 diabetes] among patients with morbid obesity.”
—Melissa Weiss
Reference:
Valderhaug TG, Sharma A, Kravdal G, Rønningen R, Nermoen I. The usage of fasting glucose and glycated hemoglobin for the identification of unknown type 2 diabetes in high risk patients with morbid obesity [published online July 17, 2017]. Scand J Clin Lab Invest. http://dx.doi.org/10.1080/00365513.2017.1347958.