Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
- Authors: Bin Zhou, Kate E Sheffer, James E Bennett, Edward W Gregg, Goodarz Danaei, Rosie K Singleton, Jonathan E Shaw, Anu Mishra, Victor P F Lhoste, Rodrigo M Carrillo-Larco, Andre P Kengne, Nowell H Phelps, Rachel A Heap, Archie W Rayner, Gretchen A Stevens, Chris J Paciorek, Leanne M Riley, Melanie J Cowan, Stefan Savin, Stephen Vander Hoorn, Yuan Lu, Meda E Pavkov, Giuseppina Imperatore, Carlos A Aguilar-Salinas, Noor Ani Ahmad, Ranjit Mohan Anjana, Kairat Davletov, Farshad Farzadfar, Clicerio González-Villalpando, Young-Ho Khang, Hyeon Chang Kim, Tiina Laatikainen, Avula Laxmaiah, Jean Claude N Mbanya, K M Venkat Narayan, Ambady Ramachandran, Alisha N Wade, Tomasz Zdrojewski, Mohsen Abbasi-Kangevari, Hanan F Abdul Rahim, Niveen M Abu-Rmeileh, Shalkar Adambekov, Robert J Adams, Wichai Aekplakorn, Imelda A Agdeppa, Javad Aghazadeh-Attari, Charles Agyemang, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadi, Soheir H Ahmed, Kamel Ajlouni, Halima Al-Hinai, Badreya Al-Lahou, Jawad A Al-Lawati, Deena Al Asfoor, Nawal M Al Qaoud, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Maryam A Aldwairji, Mohamed M Ali, Farbod Alinezhad, Abdullah Alkandari, Husam F Alomirah, Eman Aly, Deepak N Amarapurkar, Lars Bo Andersen, Sigmund A Anderssen, Dolores S Andrade, Alireza Ansari-Moghaddam, Hajer Aounallah-Skhiri, Tahir Aris, Nimmathota Arlappa, Krishna K Aryal, Felix K Assah, Batyrbek Assembekov, Juha Auvinen, Mária Avdičová, Kishwar Azad, Mohsen Azimi-Nezhad, Fereidoun Azizi, Flora Bacopoulou, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R Banegas, Carlo Maria Barbagallo, Alberto Barceló, Maja Baretić, Lena Barrera, Abdul Basit, Anwar M Batieha, Aline P Batista, Louise A Baur, Antonisamy Belavendra, Habiba Ben Romdhane, Mikhail Benet, Salim Berkinbayev, Antonio Bernabe-Ortiz, Ximena Berrios Carrasola, Heloísa Bettiol, Augustin F Beybey, Santosh K Bhargava, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Jose G Boggia, Marialaura Bonaccio, Alice Bonilla-Vargas, Herman Borghs, Pascal Bovet, Imperia Brajkovich, Hermann Brenner, Lizzy M Brewster, Garry R Brian, Yajaira Briceño, Miguel Brito, Anna Bugge, Frank Buntinx, Antonio Cabrera de León, Roberta B Caixeta, Günay Can, Ana Paula C Cândido, Mario V Capanzana, Naděžda Čapková, Eduardo Capuano, Rocco Capuano, Vincenzo Capuano, Viviane C Cardoso, Axel C Carlsson, Felipe F Casanueva, Laura Censi, Marvin Cervantes-Loaiza, Parinya Chamnan, Snehalatha Chamukuttan, Queenie Chan, Fadi J Charchar, Nish Chaturvedi, Huashuai Chen, Bahman Cheraghian, María-Dolores Chirlaque, Jerzy Chudek, Renata Cifkova, Massimo Cirillo, Frank Claessens, Emmanuel Cohen, Hans Concin, Cyrus Cooper, Simona Costanzo, Chris Cowell, Ana B Crujeiras, Juan J Cruz, Felipe V Cureau, Sarah Cuschieri, Graziella D'Arrigo, Eleonora d'Orsi, Jean Dallongeville, Albertino Damasceno, Saeed Dastgiri, Amalia De Curtis, Giovanni de Gaetano, Stefaan De Henauw, Mohan Deepa, Vincent DeGennaro Jr, Stefaan Demarest, Elaine Dennison, Valérie Deschamps, Meghnath Dhimal, Zivka Dika, Shirin Djalalinia, Chiara Donfrancesco, Guanghui Dong, Maria Dorobantu, Marcus Dörr, Nico Dragano, Wojciech Drygas, Yong Du, Charmaine A Duante, Priscilla Duboz, Anar Dushpanova, Elzbieta Dziankowska-Zaborszczyk, Narges Ebrahimi, Ricky Eddie, Ebrahim Eftekhar, Vasiliki Efthymiou, Eruke E Egbagbe, Sareh Eghtesad, Mohammad El-Khateeb, Jalila El Ati, Denise Eldemire-Shearer, Roberto Elosua, Ofem Enang, Rajiv T Erasmus, Raimund Erbel, Cihangir Erem, Gul Ergor, Louise Eriksen, Johan G Eriksson, Ali Esmaeili, Roger G Evans, Ildar Fakhradiyev, Caroline H Fall, Elnaz Faramarzi, Mojtaba Farjam, Yosef Farzi, Mohammad Reza Fattahi, Asher Fawwad, Francisco J Felix-Redondo, Trevor S Ferguson, Daniel Fernández-Bergés, Marika Ferrari, Catterina Ferreccio, Haroldo S Ferreir
- Publication year: 2023
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/619472
Abstract
Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.