Endocrine Abstracts

Introduction

When we talk about the prevalence of diabetes on a planetary scale, we can speak of a global epidemic or even a pandemic. Its prevalence continues to increase and the detection of individuals at risk of developing this disease remains a major concern.

Aim of the study

To attempt to establish standards for HbA1c by assessing the validity of this test in the diagnosis of pre-diabetic conditions and in normal subjects. This test has not yet been validated by Algerian national studies.

Material and methods

345 women, 155 men consultants at the level of primary care structures, volunteers, but at high risk of diabetes, are subjected to a questionnaire (specifying all the anthropometric parameters and the risk factors of diabetes: family and personal history of Type 2 diabetes mellitus (Type 2 DM), hypertension obesity, dyslipidemia.), then screening by performing an OGTT/HbA1c (HPLC), blood count and ophthalmologic examination. The correlation between 2 qualitative variables was analyzed by the Pearson correlation coefficient. The significance level of the tests was P ≤ 0.05 (5%). The sensitivity and specificity of HbA1c at different thresholds for the diagnosis of diabetes and pre-diabetes were studied by ROC curve. The diagnostic performance of HbA1c was assessed by the areas under the ROC curve (AUC) estimated by the DeLong method.

Results

For the diagnosis of pre-diabetes, the optimal HbA1c threshold is 5.83%, with a sensitivity of 71%) and a specificity of 81%, PPV: 80.6%, NPV: 72%.

The HbA1c at the threshold ≥ 5.7% of the ADA seems more interesting for screening the maximum number of diabetics (98%) than that of prediabetes (67%). Our HbA1c threshold ≥ 5.83% being less sensitive to detect dysglycaemia compared to that of ADA (92% of (Type 2DM) and 54% prediabetes).

Conclusion

The use of HbA1c by the standardized method may be a means of screening in high-risk subjects. This HbA1C screening strategy must be verified at the level of the general Algerian population and involves periodic evaluation.