Determine the Diagnostic Accuracy of HbA1C for Detection of Diabetes Mellitus by Taking Fasting Blood Sugar as Gold Standard

Abstract

Background: HbA1c is now formally endorsed in many countries as a diagnostic test for (type 2) diabetes as well as for monitoring, although some debate still continues regarding its applicability for diagnosis. Objective: The objective of the study was to: Determine the diagnostic accuracy of HbA1C for detection of diabetes mellitus by taking fasting blood sugar as gold standard. Study Design: Cross Sectional Study (Validation). Setting: Medical department, Allied Hospital, Faisalabad. Duration of Study: 6 Months Duration from 25-02-2015 to 25-08-2015. Methodology: A total of 145 cases with more than 40 years of age of either gender were enrolled in the study. Informed consent was taken from each participant of the study from medical department, Allied Hospital, Faisalabad. Information was collected by trainee researcher and comprised age, Gender, address and contact number, HbA1C and Fasting Blood Sugar. HbA1C and Fasting blood sugar was measured by drawing 3cc blood from a peripheral vein after antiseptic measures and sent to pathology laboratory, Allied Hospital, Faisalabad where it was reported by Pathologist. All the information was collected on Performa by Principal Investigator. Results: In our study, 71.72% (n=104) were between 40-60 years while 28.28% (n=41) had >60 years of age, mean ± sd was calculated as 56.75±6.45 years, 52.41% (n=76) were male and 47.59% (n=69) were females, frequency of diabetes mellitus on gold standard was recorded as 26.21% (n=38) while 73.79% (n=107) had no findings of the morbidity. Diagnostic accuracy of HbA1C for detection of diabetes mellitus by taking fasting blood sugar as gold standard was calculated for sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate as 78.95%, 83.17%, 62.15%, 91.75% and 82.07% respectively. Conclusion: We concluded that the diagnostic accuracy of HbA1C at cutoff point more than 6.15% for detection of diabetes mellitus by taking fasting blood sugar as gold standard is high and this modality can be used in our population.