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A Comparative Study: Elevated HbA1c and Fasting Blood Sugar (FBS) Levels in Clinically Suspected Cases of Type 2 DM.

Parul Dargar, Assistant Professor, Dept. of Pathology, Index Medical College, Hospital and Research Centre, Indore, Madhya Pradesh 452001, India , Shahar Bano Khan1 , Anil Kapoor2 , S.K. Nema3 , Neelambara Bidwai4 , Parul Dargar5 , Parwez Qureshi6

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Indian Journal of Pathology: Research and Practice 7(8):p 934-937, August 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7818.9

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Abstract

Background: Although glycated hemoglobin (HbA1c) has recently been incorporated as a diagnostic test in comparison by FBS by the ADA, its validity needs to be established in a community setting.

Objective: To assess the efficacy of HbA1c as a screening and diagnostic test in clinically suspected cases diabetes mellitus and comparison of statistical parameters of HbA1c and FBS.

Materials And Method: Cross sectional study was conducted in Indore, MP at IMCHRC, from July 2015- July 2017 on 430 clinically suspected cases of DM. Intervention included an FBS and HbA1c in all the subjects.

Results: Using ADA criteria of diabetes that is FBS >126mg/dl we got sensitivity of 36.59%, specificity of 96.05%, PPV of 96.08%, NPV of 32.02% and accuracy of 50.69%. HbA1c level at 6.5% had sensitivity 91.94%, specificity 45.42%, PPV 40.57%, NPV 93.29% and accuracy 50.69%. HbA1c level of 5.7% had an sensitivity of 96.77%, specificity 32.03%, PPV 36.58%, NPV 96.08% and accuracy 49.30%. HbA1c level of 6.0 had sensitivity 95.97%, specificity 38.56%, PPV of 38.76%, NPV of 95.93% and accuracy 55.11% for diagnosis of DM.

Conclusion: HbA1c cut point of 6.0% had an optimal sensitivity and specificity of 95.97% and 38.76% respectively, with maximum accuracy of 55.1% and can be used as a screening test anda cutoff point of 6.5% has optimal specificity of 45.45 and NPV of 93.29% and can be used for diagnosis of diabetes. Moreover both HbA1c and FBS should be used together for screening to balance their individual weak parameters.

Keywords: HbA1c; FBS; Accuracy.

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7818.9

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