Glycated haemoglobin A1c compared to fasting plasma glucose and oral glucose tolerance testing for diagnosing type 2 diabetes and pre-diabetes : a meta-analysis

dc.contributor.advisorRheeder, Paulen
dc.contributor.emailsusu0827@gmail.comen
dc.contributor.postgraduateShao, Jingen
dc.date.accessioned2015-01-19T12:13:15Z
dc.date.available2015-01-19T12:13:15Z
dc.date.created2014/12/12en
dc.date.issued2014en
dc.descriptionDissertation (MSc)--University of Pretoria, 2014.en
dc.description.abstractBACKGROUND In 2010, glycated haemoglobin A1c (HbA1c) was officially recommended as a screening tool to diagnose type 2 diabetes mellitus (T2DM) and pre-diabetes, with cut-off points 6.5% and 5.7% to 6.4% respectively. The implications of using the HbA1c criterion, compared to the general diagnostic criteria: fasting glucose test (FPG) and oral glucose tolerance test (OGTT), is however still being debated. OBJECTIVES The objectives of this study were to evaluate and compare the pooled prevalence of type 2 diabetes mellitus (T2DM) and pre-diabetes, as measured by the Haemoglobin A1c (HbA1c) test, or the fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). Secondly, to determine and compare the diagnostic test characteristics (sensitivity, specificity) of these tests. METHODS Published papers, with a cross sectional study design, were selected for a systematic review and meta-analysis. The search strategy was an electronic review of journal articles listed on MEDLINE, PubMed and Google scholar between 1996 and 2012. Reference lists were checked, journals were hand searched and experts were contacted when necessary. Initially all studies related to the validation of HbA1c as a tool to detect pre-diabetes or T2DM in humans, published in English, were examined. Studies were excluded if they did not meet the above mentioned criteria, and/or were conducted with pregnant women. Further analysis was done if FPG or OGTT was compared to HbA1c. The diagnosis of diabetes had to have been based on ADA or WHO criteria. These criteria are: HbA1c 5.7%-6.4% for pre-diabetes and >=6.5% for T2DM; FPG 5.6mmol-7mmol/l for pre-diabetes and >=7mmol/l for T2DM; OGTT 7.8mmol-11.1mmol/l for pre-diabetes and >=11.1mmol/l for T2DM). The OGTT and FPG tests were used as the reference tests and the prevalence reflected as a positive or negative proportion. The sensitivity and specificity of HbA1c >=6.5% among cases defined by OGTT or FPG should have been reported, or it was possible to calculate these from the data provided. Study results relating to diagnostic accuracy were extracted and synthesized using multivariate random effects meta-analysis methods. This study focused on patients who were suspected of having T2DM, from two sub-groups (a community-based group and a high-risk group) to compare the detection rate of HbA1c with FPG and OGTT.en
dc.description.availabilityUnrestricteden
dc.description.degreeMScen
dc.description.departmentSchool of Health Systems and Public Health (SHSPH)en
dc.description.librarianlk2014en
dc.identifier.citationShao, J 2014, Glycated haemoglobin A1c compared to fasting plasma glucose and oral glucose tolerance testing for diagnosing type 2 diabetes and pre-diabetes : a meta-analysis, MSc Dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/43240>en
dc.identifier.otherM14/9/402en
dc.identifier.urihttp://hdl.handle.net/2263/43240
dc.language.isoenen
dc.publisherUniversity of Pretoriaen_ZA
dc.rights© 2014 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.en
dc.subjectType 2 diabetes mellitus (T2DM)en
dc.subjectMeta-analysisen
dc.subjectHbA1cen
dc.subjectDiagnosis screeningen
dc.subjectSystematic reviewen
dc.subjectUCTDen
dc.titleGlycated haemoglobin A1c compared to fasting plasma glucose and oral glucose tolerance testing for diagnosing type 2 diabetes and pre-diabetes : a meta-analysisen
dc.typeDissertationen

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