Does HbA1C predict isolated impaired fasting glycaemia in the oral glucose tolerance test in subjects with impaired fasting glycaemia?

Ann Clin Biochem 2008;45:418-420
© 2008 Association for Clinical Biochemistry


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Original Articles

Taruna Likhari1,
T S Aulakh2,
Baldev M Singh3 and
R Gama1,4

1 Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP, UK;
2 Outcome Centre, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY10 7AG, UK;
3 Department of Diabetes, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP, UK;
4 Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, West Midlands WV1 1SB, UK

Corresponding author: Dr Taruna Likhari, Department of Clinical Biochemistry, Manor Hospital, Walsall, West Midlands WS2 9PS, UK. Email: Taruna.likhari{at}

Background: To assess the usefulness of erythrocyte glycated haemoglobin (HbA1C) as a screening tool to identify those subjects withimpaired fasting glycaemia (IFG) who do not have impaired glucosetolerance (IGT) or diabetes mellitus (DM) on a 75 g oral glucosetolerance test (OGTT).

Design and methods: All subjects undergoing an OGTT had HbA1C measured at baseline. Receiver operator characteristics analysis was used to identify optimal HbA1C cut-off values for diagnosing and excluding IGTand DM.

Results: We studied 140 subjects (69 women) with IFG (fasting capillary plasma glucose between 6.1–6.9 mmol/L). Using World Health Organisation criteria, 27 had isolated IFG, 56 had IGT and 57 had DM. HbA1C was higher (P < 0.001) in patients with DM (6.8 ± 0.93%) when compared with those with IGT (6.3 ± 0.68%) and isolated IFG (6.2 ± 0.30%), but HbA1C was similar in those with IGT and isolated IFG. There was no HbA1C cut-off value differentiating isolated IFG from IGT or DM. None of the subjects with isolated IFG had HbA1C concentration of >6.8%, but 76% and 54% subjects with IGT and DM, respectively, had HbA1C of ≤6.8%.

Conclusions: HbA1C measurement is of limited value in differentiating isolatedIFG, IGT and DM in subjects with IFG. It cannot be used to identifywhich subjects with IFG do not require an OGTT.

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