Endocrine Abstracts

Introduction: ‘PreDiabetes’ was considered as a categories of increased risk for diabetes on the last ADA recommendations in 2010. The proposed diagnostic criteria include an HbA1c value between 5.7 and 6.4%, impaired fasting glucose (IFG) (100–125 mg/dl) and impaired glucose tolerance (IGT) levels (2-h values in the oral glucose tolerance test (OGTT) of 140 to 199 mg/dl). The HbA1c as new diagnostic criteria may actually increase the number of patients diagnosed with PreDiabetes. Although this issue is controversial, originating a large discussion from different authors.

Objective: To compare the 3 mentions tests for the evaluation of dysglycemia on overweight population, without previous the diagnosis of PreDiabetes or Diabetes.

Methods: Observational study performed in our department. Clinical history was recalled and anthropometric measurements were performed in all participants: weight, height, waist circumference (WC) and % fat mass (FM). Glycaemia, lipids and blood pressure levels were measured in all patients. Three diagnostic criteria were considered: IFG, IGT and HbA1c value. Statistic tests (T-test, X² test, Fisher test) were used to compare the differences between variables.

Results: The study included 53 individuals, with a mean age of 52 years, 66% being females. Between females and males, the mean weight was 81 vs 90 kg, BMI of 33 vs 31 kg/m², WC 99.5 vs 104 cm and % FM of 40.5 vs 28.3%. Using only one diagnostic criteria, the PreDiabetes prevalence was 13.2% with FG, 9.4% with OGTT and 26.4% with HbA1c. Using the 3 criteria simultaneously, only 3.8% of the patients had PreDiabetes and none has diabetes.

Conclusions: Despite the high percentage of possible PreDiabetes based on HbA1c levels, this is not confirmed when all criteria are simultaneously used. Due to the low concordance between the 3 methods, other studies are required to evaluate the interests of HbA1c as new criteria for PreDiabetes diagnosis.