Featured Research

from universities, journals, and other organizations

Hemoglobin A1c outperforms fasting glucose for risk prediction

Date:
March 10, 2010
Source:
Johns Hopkins University Bloomberg School of Public Health
Summary:
Measurements of hemoglobin A1c (HbA1c) more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose, according to a new study. HbA1c levels accurately predict future diabetes, and they better predict stroke, heart disease and all-cause mortality as well.

Measurements of hemoglobin A1c (HbA1c) more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. HbA1c levels accurately predict future diabetes, and they better predict stroke, heart disease and all-cause mortality as well.

The study appeared in the March 4, 2010, issue of New England Journal of Medicine.

As a diagnostic, "HbA1c has significant advantages over fasting glucose," said Elizabeth Selvin, PhD, MPH, the study's lead author. The A1c test has low variability from day to day, levels are not as affected by stress and illness, it has greater stability and the patient is not required to fast before the test is performed.

This study is published on the heels of a major change in the way doctors diagnose diabetes. In January, the American Diabetes Association (ADA) published revised recommendations for the screening and diagnosis of diabetes. The revised recommendations include, for the first time, recommendations to use HbA1c to diagnose diabetes and also to identify people at risk of developing diabetes in the future, also known as "pre-diabetes."

The new findings can help doctors and patients interpret HbA1c test results. In the study, people with HbA1c levels between 5.0 to 5.5 percent were identified as being within "normal" range. The majority of the U.S. adult population is within this range. With each incremental HbA1c increase, the study found, the incidence of diabetes increased as well; those at a level of 6.5 percent or greater are considered diabetic, and those between 6.0 and 6.5 percent are considered at a "very high risk" (9 times greater than those at the "normal" range) for developing diabetes.

The revised ADA guidelines classify people with HbA1c levels in the range of 5.7 to 6.4 percent as "at very high risk" for developing diabetes over 5 years. The range of 5.5 to 6 percent, according to the ADA guidelines, is the appropriate level to initiate preventive measures.

The study measured HbA1c in blood samples from more than 11,000 people, black and white adults, who had no history of diabetes. The samples were obtained between 1990 and 1992 as part of the Atherosclerosis Risk in Communities (ARIC) Study at four ARIC field centers in Hagerstown, Md. (the George W. Comstock Center for Public Health Research and Prevention), Minneapolis, Minn. (University of Minnesota), Jackson, Miss. (University of Mississippi Medical Center) and Forsyth County, N.C. (University of North Carolina). The samples have been in cold storage since their collection. "It is amazing to be able to use blood samples collected over a decade ago," said Selvin, because researchers were able to look at participants' measurements and compare to outcomes that occurred during 15 years of follow-up.

Currently there are 9 million Americans who are diabetic but undiagnosed. "These data," said Selvin "can help us interpret A1c values in clinical practice and help identify people who need treatment the most."

This research was supported by NIH/NIDDK grants and the Johns Hopkins Diabetes Research and Training Center. The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute.


Story Source:

The above story is based on materials provided by Johns Hopkins University Bloomberg School of Public Health. Note: Materials may be edited for content and length.


Journal Reference:

  1. Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, Coresh J, Brancati FL. Glycated Hemoglobin, Diabetes, and Cardiovascular Risk in Nondiabetic Adults. New England Journal of Medicine, 2010; 362 (9): 800 DOI: 10.1056/NEJMoa0908359

Cite This Page:

Johns Hopkins University Bloomberg School of Public Health. "Hemoglobin A1c outperforms fasting glucose for risk prediction." ScienceDaily. ScienceDaily, 10 March 2010. <www.sciencedaily.com/releases/2010/03/100303192434.htm>.
Johns Hopkins University Bloomberg School of Public Health. (2010, March 10). Hemoglobin A1c outperforms fasting glucose for risk prediction. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2010/03/100303192434.htm
Johns Hopkins University Bloomberg School of Public Health. "Hemoglobin A1c outperforms fasting glucose for risk prediction." ScienceDaily. www.sciencedaily.com/releases/2010/03/100303192434.htm (accessed October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com
Doctors Help Paralysed Man Walk Again, Patient in Disbelief

Doctors Help Paralysed Man Walk Again, Patient in Disbelief

AFP (Oct. 22, 2014) Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins