Tuesday, November 03, 2009

HbA1c better predictor retinopathy than FPG in US population



According to a
study published in Diabetes Care, glycated hemoglobin (HbA1c) is a better predictor of retinopathy prevalence in the general population than fasting plasma glucose (FPG).
Diabetes is a disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly. Insulin is the hormone that regulates the level of sugar (glucose) in the blood. Diabetes can affect children and adults. Patients with diabetes are more likely to develop eye problems such as cataract or glaucoma., but the main threat to vision is its effect on the retina.

Researchers analyzed data from 1,066 people, including values for HbA1c, FPG, and 45 degree color digital retinal images. After using area under the receiver operator curve analysis...the team found that HbA1c was a significantly stronger discriminator of retinopathy than FPG.

While diabetic retinopathy, or more specifically its associated threshold FPG value of 7.0 mmol/l, has been used in diagnostic criteria for type 2 diabetes by the American Diabetes Association, this study confirms...that HbA1c levels could be a superior measure for predicting retinopathy risk to FPG and may be more appropriate for use in diagnosing type 2 diabetes, the authors said.

Cheng et al conclude: “While the HbA1c and FPG levels of 5.5% and 5.8 mmol/l provide start points at which retinopathy prevalence increases most precipitously, HbA1c appears to discriminate between the presence and absence of retinopathy at least as well as FPG and offers some advantages over FPG.”

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