Korean J Fam Pract. 2016; 6(5): 524-527  https://doi.org/10.21215/kjfp.2016.6.5.524
Comparison of Hemoglobin A1c and Fasting Blood Glucose for Diagnosis of Diabetes in Korea
Kun Woo Kim, Yu-Lee Kim*, Su Hwan Kim, Yujin Kim, In Jeong Cho
Department of Family Medicine, Busan Medical Center, Busan, Korea
Yu-Lee Kim
Tel: +82-51-507-3000, Fax: +82-51-507-3001
E-mail: 0772052@hanmail.net
Received: February 24, 2016; Revised: July 14, 2016; Accepted: July 27, 2016; Published online: October 20, 2016.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

Background: Glycated hemoglobin A1c (HbA1c) has been recommended as a diagnostic test for diabetes by the American Diabetes Association since 2010. However, there may be differences in HbA1c values according to race, sex, and age. We compared HbA1c and fasting blood glucose (FBG) test results for the diagnosis of diabetes.

Methods: We analyzed the data of 3,421 adults (aged ≥30 years) who were not diagnosed with diabetes mellitus, derived from the 2014 Korean National Health and Nutrition Examination Survey. The following criteria were used for the diagnosis of diabetes mellitus; HbA1c ≥6.5% and FBG level ≥126 mg/mL.

Results: The kappa index of agreement between FBG and HbA1c criteria was 0.60. For a diagnosis of diabetes based on the FBG level, the HbA1c cutoff value was 6.1%, with a sensitivity of 88.7% and a specificity of 89.1% (area under the curve 0.889).

Conclusion: There was moderate concordance between HbA1c and FBG criteria for the diagnosis of diabetes in Korean adults. As HbA1c may be affected by race, sex, or age, further large-scale, population-based studies on diabetes complications are required to evaluate the role of HbA1c in the diagnosis of diabetes in Korea.

Keywords: Diabetes Mellitus; Hemoglobin A1c; Fasting Blood Glucose; Diagnosis
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