- Title
- Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
- Creator
- Zhou, Bin; Sheffer, Kate; Bennett, James; Gregg, Edward; Danaei, Goodarz; Singleton, Rosie; Shaw, Jonathan; Mishra, Anu; Lhoste, Victor; Carrillo-Larco, Rodrigo; Kengne, Andre; Phelps, Nowell; Heap, Rachel; Rayner, Archie; Stevens, Gretchen; Paciorek, Chris; Riley, Leanne; Cowan, Melanie; Savin, Stefan; Vander Hoorn, Stephen; Lu, Yuan; Pavkov, Meda; Imperatore, Giuseppina; Aguilar-Salinas, Carlos; Ahmad, Noor; Anjana, Ranjit; Davletov, Kairat; Farzadfar, Farshad; González-Villalpando, Clicerio; Charchar, Fadi
- Date
- 2023
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/198888
- Identifier
- vital:19129
- Identifier
-
https://doi.org/10.1038/s41591-023-02610-2
- Identifier
- ISSN:1078-8956 (ISSN)
- Abstract
- 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. © 2023, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Fadi Charchar" is provided in this record**
- Publisher
- Nature Research
- Relation
- Nature Medicine Vol. 29, no. 11 (2023), p. 2885-2901
- Rights
- All metadata describing materials held in, or linked to, the repository is freely available under a CC0 licence
- Rights
- http://creativecommons.org/licenses/by/4.0/
- Rights
- Copyright © 2023, The Author(s)
- Rights
- Open Access
- Subject
- 32 Biomedical and clinical sciences; 42 Health sciences
- Full Text
- Reviewed
- Funder
- This study was funded by the UK Medical Research Council (grant number MR/V034057/1 to M.E.), the UK Research and Innovation (Research England Policy Support Fund to M.E.) and the US Centers for Disease Control and Prevention (to E.W.G.). B. Zhou is supported by a fellowship from the Abdul Latif Jameel Institute for Disease and Emergency Analytics, funded by a donation from Community Jameel, at Imperial College London.
- Hits: 263
- Visitors: 263
- Downloads: 2
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | Published version | 1 MB | Adobe Acrobat PDF | View Details Download |