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Incidence of type 2 diabetes by HbA1c and OGTT: the Isfahan Diabetes Prevention Study

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Abstract

The aim of this study was to estimate the incidence of type 2 diabetes using newly proposed hemoglobin A1C (HbA1c) and current oral glucose tolerance test (OGTT) definition in an Iranian non-diabetic population. A total of 923 non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes 30–70 years old in 2003–2005 were followed through 2009 for the occurrence of type 2 diabetes. At baseline and through follow-ups, participants underwent a standard 75 g 2-h OGTT and HbA1c measurements. Prediction of progression to type 2 diabetes by OGTT-defined or HbA1c-defined diabetes was assessed with area under the receiver operating characteristic (ROC) curves based upon measurement of fasting plasma glucose, 2-h post-load glucose values, and HbA1c. The prevalence of type 2 diabetes was 9.2% (95% CI: 8.2, 10.2) by OGTT-defined diabetes and 7.9% (95% CI: 6.9, 9.0) by HbA1c ≥6.5. The incidence of type 2 diabetes was 2.0% (95% CI: 1.6, 2.4) (1.8% men and 2.1% women) per year by the current OGTT definition, whereas the incidence rates were 1.7% (95% CI: 1.3, 2.0) (1.6% men and 1.7% women) per year by HbA1c ≥6.5%. Of those diagnosed with type 2 diabetes by OGTT, 69.6% had HbA1c <6.5% and therefore would not have been classified as having type 2 diabetes. The incidence and prevalence of diabetes using newly proposed HbA1c threshold in this FDRs of patients with type 2 diabetes were slightly lower than using current OGTT definition.

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Acknowledgments

This work was supported by grants from the Isfahan Endocrine and Metabolism Research Center, Iran. The authors are grateful to Mr. Majid Abyar for computer technical assistance. This study could not have been conducted without the contribution of the FDRs of patients with type 2 diabetes who consented to participate.

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None.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohsen Janghorbani

  2. Department of Epidemiology and Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohsen Janghorbani & Masoud Amini

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  1. Mohsen Janghorbani
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  2. Masoud Amini
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Correspondence to Mohsen Janghorbani.

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Janghorbani, M., Amini, M. Incidence of type 2 diabetes by HbA1c and OGTT: the Isfahan Diabetes Prevention Study. Acta Diabetol 49 (Suppl 1), 73–79 (2012). https://doi.org/10.1007/s00592-011-0260-6

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  • DOI: https://doi.org/10.1007/s00592-011-0260-6

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