Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Autor(en)

, Bin Zhou, Kate E. Sheffer, James E. Bennett, Edward W. Gregg, Goodarz Danaei, Rosie K. Singleton, Jonathan E. Shaw, Anu Mishra, Victor P.F. Lhoste, Rodrigo M. Carrillo-Larco, Andre P. Kengne, Nowell H. Phelps, Rachel A. Heap, Archie W. Rayner, Gretchen A. Stevens, Chris J. Paciorek, Leanne M. Riley, Melanie J. Cowan, Stefan Savin, Stephen Vander Hoorn, Yuan Lu, Meda E. Pavkov, Giuseppina Imperatore, Carlos A. Aguilar-Salinas, Noor Ani Ahmad, Ranjit Mohan Anjana, Kairat Davletov, Farshad Farzadfar, Clicerio González-Villalpando, Young Ho Khang, Hyeon Chang Kim, Tiina Laatikainen, Avula Laxmaiah, Jean Claude N. Mbanya, K. M.Venkat Narayan, Ambady Ramachandran, Alisha N. Wade, Tomasz Zdrojewski, Mohsen Abbasi-Kangevari, Hanan F.Abdul Rahim, Niveen M. Abu-Rmeileh, Shalkar Adambekov, Robert J. Adams, Wichai Aekplakorn, Imelda A. Agdeppa, Javad Aghazadeh-Attari, Charles Agyemang, Ali Ahmadi, Jürgen König, Petra Rust

Abstrakt

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.

Organisation(en)

Department für Ernährungswissenschaften

Externe Organisation(en)

Imperial College London, Royal College of Surgeons in Ireland, Harvard University, Baker IDI Heart and Diabetes Institute, Bill & Melinda Gates Foundation, Emory University, South African Medical Research Council, WHO - World Health Organization, University of California, Berkeley, University of Auckland, Yale University, US Centres for Disease Control and Prevention, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ministry of Health, University of Madras, Asfendiyarov Kazakh National Medical University, Tehran University of Medical Sciences, Instituto Nacional de Salud Publica, Seoul National University College of Medicine, National Institute for Health and Welfare, Indian Council of Medical Research, Université de Yaoundé I, India Diabetes Research Foundation, University of Witwatersrand, Medical University of Gdańsk, Shiraz University of Medical Sciences, Qatar University, Birzeit University, Al-Farabi Kazakh National University, Flinders University, Mahidol University (MU), Food and Nutrition Research Institute, Urmia University of Medical Sciences, University of Amsterdam (UvA), Shahrekord University, Yonsei University

Journal

Nature Medicine

Band

29

Seiten

2885-2901

Anzahl der Seiten

17

ISSN

1078-8956

DOI

https://doi.org/10.1038/s41591-023-02610-2

Publikationsdatum

11-2023

Peer-reviewed

Ja

ÖFOS 2012

303009 Ernährungswissenschaften

ASJC Scopus Sachgebiete

Biochemistry, Genetics and Molecular Biology(all)

Sustainable Development Goals

SDG 3 – Gesundheit und Wohlergehen

Link zum Portal

https://ucrisportal.univie.ac.at/de/publications/global-variation-in-diabetes-diagnosis-and-prevalence-based-on-fasting-glucose-and-hemoglobin-a1c(26785e2a-9e73-4996-9f06-51abbc03a73f).html