Endocrine Abstracts

Objectives: The number of people with diabetes is increasing globally; hence necessitate identifying diabetes earlier and more efficiently. Recently, American Diabetes Association (ADA) recommended the use of glycated haemoglobin (HbA1c) as an alternative to glucose based criteria for diagnosing type 2 diabetes and pre-diabetes. Hence, we aimed to evaluate the discrepancies between HbA1c- and glucose-based criteria for diagnosis of diabetes and pre-diabetes in Nepalese population.

Methods: A total of 2502 subjects aged 30 years or older, who attended university hospital and subjected for measurement of HbA1c, fasting plasma glucose (FPG) and 2-hour plasma glucose (PPG) level were recruited in the study. Newly diagnosed diabetes and pre-diabetes were defined by ADA-glucose based and ADA- HbA1c criteria. Statistical analyses were performed using SPSS software to evaluate discripancies.

Results: The percentages of newly diagnosed individuals with diabetes were 12.87% (322/2502) using the FPG criterion alone, 12.07% (302/2502) using the PPG criterion alone, 14.55% (364/2502) using the HbA1c criterion alone and 10.51% (263/2502) using FFG, PPG & HbA1c criteria in combination. Significant discordance occurred for 3.28% (82/2502) with HbA1c- and glucose-based criteria and for 1.68% (42/2502) with HbA1c- and FPG-criteria. Among the study subjects, 2.86% of individuals with a FBG and 2.12% of individuals with HbA1c were found to be pre-diabetes.

Conclusions: Significant discordance exists between the HbA1c- and glucose-based diagnostic criteria for diagnosis of diabetes and pre-diabetes in Nepalese population. Hence, we concluded that using glucose based criteria merely may result in an underestimation of diabetes and pre-diabetes.