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American Journal of Epidemiology Vol. 122, No. 4: 589-593
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health

research-article

COMPARISON OF GLYCOSYLATED HEMOGLOBIN AND FASTING PLASMA GLUCOSE WITH TWO-HOUR POST-LOAD PLASMA GLUCOSE IN THE DETECTION OF DIABETES MELLITUS

D. SIMON1,2,, M. C. COIGNET3, N. THIBULT1, C. SENAN4 and E. ESCHWEGE1,3

1 Unité de Recherches Statistiques, INSERM U 21, Villejuif, France
2Département de Santé Publique, Hôpital Henri-Mondor Créteil, France
3Hôpital Hôtel-Dieu Paris, France
4Unité de Recherches en Génétique Moléculaire et en Hématologie, INSERM U 91, Créteil, France

Reprint requests to Dr. Dominique Simon, INSERM—Unité 21, 16, Avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France

In the course of a screening for diabetes mellitus in the Hôtel-Oieu Hospital in Paris, from September 15, 1981 to April 1, 1984, an oral glucose tolerance test and a measurement of glycosytated hemoglobin were performed on 333 outpatients. With two-hour plasma glucose as a reference, the sensitivities of glycosylated hemoglobin, fasting plasma glucose, and a combination of glycosyiated hemoglobin and fasting plasma glucose equal, respectively, 60.0%, 52.0%, and 40.0%; the specificities 90.9%, 98.7%, and 99.4%; the predictive value for a positive diagnosis 34.9%, 76.5%, and 83.3%. If one takes into account the implications of diabetes mellitus, especially its economic and psycnosodologtc consequences, it seems better for diagnosis—from a public health point of view—to use tests with a high degree of specificity and a high predictive value for a positive diagnosis, such as the combination of fasting plasma glucose and glycosyiated hemoglobin, than tests with a good sensitivity but poor specificity. In the long term, validation of glycosyiated hemoglobin as a diagnostic test for asymptomatic diabetes mellitus will be obtained only by reference to unquestionable criteria of the disease, determined by longitudinal survey.

diabetes mellitus; diagnosis; glucose tolerance test; hemoglobin A; glycosyiated


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