Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
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Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c

  • Jeon, Ja Young (Department of Endocrinology and Metabolism, Ajou University School of Medicine) ;
  • Ko, Seung-Hyun (Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kwon, Hyuk-Sang (Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Nan Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Jae Hyeon (Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Chul Sik (Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Song, Kee-Ho (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Won, Jong Chul (Department of Internal Medicine, Mitochondrial Research Group, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Lim, Soo (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Choi, Sung Hee (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Jang, Myoung-Jin (Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention) ;
  • Kim, Yuna (Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention) ;
  • Oh, Kyungwon (Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention) ;
  • Kim, Dae Jung (Department of Endocrinology and Metabolism, Ajou University School of Medicine) ;
  • Cha, Bong-Yun (Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association (Korean Diabetes Association)
  • Received : 2013.07.23
  • Accepted : 2013.08.23
  • Published : 2013.10.17
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Abstract

Background: Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. Methods: Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ${\geq}126mg/dL$, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ${\geq}6.5%$. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. Results: When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ${\geq}6.5%$ and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. Conclusion: We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.

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