Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants
link https://doi.org/10.1016/S2213-8587(15)00129-1account_box Danaei, Goodarzaccount_box Fahimi, Samanaccount_box Lu, Yuanaccount_box Zhou, Binaccount_box Hajifathalian, Kavehaccount_box Di Cesare, Mariachiaraaccount_box Lo, Wei-Chengaccount_box Reis-Santos, Barbaraaccount_box Cowan, Melanie J.account_box Shaw, Jonathan E.account_box Bentham, Jamesaccount_box Lin, John K.account_box Bixby, Honoraccount_box Magliano, Diannaaccount_box Bovet, Pascalaccount_box Miranda, J. Jaimeaccount_box Khang, Young-Hoaccount_box Stevens, Gretchen A.account_box Riley, Leanne M.account_box Ali, Mohammed K.account_box Ezzati, Majidaccount_box Abdeen, Ziad A.account_box Kadir, Khalid Abdulaccount_box Abu-Rmeileh, Niveen M.account_box Acosta-Cazares, Benjaminaccount_box Aekplakorn, Wichaiaccount_box Aguilar-Salinas, Carlos A.account_box Ahmadvand, Alirezaaccount_box Al Nsour, Mohannadaccount_box Alkerwi, Ala'aaccount_box Amouyel, Philippeaccount_box Andersen, Lars Boaccount_box Anderssen, Sigmund A.account_box Andrade, Dolores S.account_box Anjana, Ranjit Mohanaccount_box Aounallah-Skhiri, Hajeraccount_box Aris, Tahiraccount_box Arlappa, Nimmathotaaccount_box Arveiler, Dominiqueaccount_box Assah, Felix K.account_box Avdicova, Mariaaccount_box Balakrishna, Nagallaaccount_box Bandosz, Piotraccount_box Barbagallo, Carlo M.account_box Barcelo, Albertoaccount_box Batieha, Anwar M.account_box Baur, Louise A.account_box Ben Romdhane, Habibaaccount_box Bernabe-Ortiz, Antonioaccount_box Bhargava, Santosh K.account_box Bi, Yufangaccount_box Bjerregaard, Peteraccount_box Bjorkelund, Ceciliaaccount_box Blake, Margaretaccount_box Blokstra, Annekeaccount_box Bo, Simonaaccount_box Boehm, Bernhard O.account_box Boissonnet, Carlos P.account_box Bovet, Pascalaccount_box Brajkovich, Imperiaaccount_box Breckenkamp, Juergenaccount_box Brewster, Lizzy M.account_box Brian, Garry R.account_box Bruno, Graziellaaccount_box Bugge, Annaaccount_box de Leon, Antonio Cabreraaccount_box Can, Gunayaccount_box Candido, Ana Paula C.account_box Capuano, Vincenzoaccount_box Carvalho, Maria J.account_box Casanueva, Felipe F.account_box Caserta, Carmelo A.account_box Castetbon, Katiaaccount_box Chamukuttan, Snehalathaaccount_box Chaturvedi, Nishiaccount_box Chen, Chien-Jenaccount_box Chen, Fangfangaccount_box Chen, Shuohuaaccount_box Cheng, Ching-Yuaccount_box Chetrit, Angelaaccount_box Chiou, Shu-Tiaccount_box Cho, Yumiaccount_box Chudek, Jerzyaccount_box Cifkova, Renataaccount_box Claessens, Frankaccount_box Concin, Hansaccount_box Cooper, Cyrusaccount_box Cooper, Rachelaccount_box Costanzo, Simonaaccount_box Cottel, Dominiqueaccount_box Cowell, Chrisaccount_box Crujeiras, Ana B.account_box D'Arrigo, Graziellaaccount_box Dallongeville, Jeanaccount_box Dankner, Rachelaccount_box Dauchet, Lucaccount_box de Gaetano, Giovanniaccount_box De Henauw, Stefaanaccount_box Deepa, Mohanaccount_box Dehghan, Abbasaccount_box Dhana, Klodianaccount_box Di Castelnuovo, Augusto F.account_box Djalalinia, Shirinaccount_box Doua, Kouamelanaccount_box Drygas, Wojciechaccount_box Du, Yongaccount_box Egbagbe, Eruke E.account_box Eggertsen, Robertaccount_box El Ati, Jalilaaccount_box Elosua, Robertoaccount_box Erasmus, Rajiv T.account_box Erem, Cihangiraccount_box Ergor, Gulaccount_box Eriksen, Louiseaccount_box la Penaa, Jorge Escobedo-Deaccount_box Fall, Caroline H.account_box Farzadfar, Farshadaccount_box Felix-Redondo, Francisco J.account_box Ferguson, Trevor S.account_box Fernandez-Berges, Danielaccount_box Ferrari, Marikaaccount_box Ferreccio, Catterinaaccount_box Finn, Joseph D.account_box Foger, Bernhardaccount_box Foo, Leng Huataccount_box Fouad, Heba M.account_box Francis, Damian K.account_box Franco, Maria do Carmoaccount_box Franco, Oscar H.account_box Frontera, Guillermoaccount_box Furusawa, Takuroaccount_box Gaciong, Zbigniewaccount_box Galbarczyk, Andrzejaccount_box Garnett, Sarah P.account_box Gaspoz, Jean-Michelaccount_box Gasull, Magdaaccount_box Gates, Louiseaccount_box Geleijnse, Johanna M.account_box Ghasemain, Anooshehaccount_box Giampaoli, Simonaaccount_box Gianfagna, Francescoaccount_box Giovannelli, Jonathanaccount_box Gross, Marcela Gonzalezaccount_box Rivas, Juan P. Gonzalezaccount_box Gorbea, Mariano Bonetaccount_box Gottrand, Fredericaccount_box Grant, Janet F.account_box Grodzicki, Tomaszaccount_box Grontved, Andersaccount_box Gruden, Grabriellaaccount_box Gu, Dongfengaccount_box Guan, Ong Pengaccount_box Guerrero, Ramiroaccount_box Guessous, Idrisaccount_box Guimaraes, Andre L.account_box Gutierrez, Lauraaccount_box Hardy, Rebeccaaccount_box Kumar, Rachakulla Hariaccount_box He, Jiangaccount_box Heidemann, Christinaccount_box Hihtaniemi, Ilpo Tapaniaccount_box Ho, Sai Yinaccount_box Ho, Suzanne C.account_box Hofman, Albertaccount_box Russo, Andrea R. V.account_box Hormiga, Claudia M.account_box Horta, Bernardo L.account_box Houti, Leilaaccount_box Hussieni, Abdullatif S.account_box Huybrechts, Ingeaccount_box Hwalla, Nahlaaccount_box Iacoviello, Liciaaccount_box Iannone, Anna G.account_box Ibrahim, Mohsen M.account_box Ikeda, Nayuaccount_box Ikram, M. Arfanaccount_box Irazola, Vilma E.account_box Islam, Muhammadaccount_box Iwasaki, Masanoriaccount_box Jacobs, Jeremy M.account_box Jafar, Tazeenaccount_box Jasienska, Grazynaaccount_box Jiang, Chao Qiangaccount_box Jonas, Jost B.account_box Joshi, Pradeepaccount_box Kafatos, Anthonyaccount_box Kalter-Leibovici, Ofraaccount_box Kasaeian, Amiraccount_box Katz, Joanneaccount_box Kaur, Prabhdeepaccount_box Kavousi, Maryamaccount_box Kelishadi, Royaaccount_box Kengne, Andre P.account_box Kersting, Mathildeaccount_box Khader, Yousef Salehaccount_box Khang, Young-Hoaccount_box Kiechl, Stefanaccount_box Kim, Jeongseonaccount_box Kiyohara, Yutakaaccount_box Kolsteren, Patrickaccount_box Korrovits, Paulaccount_box Koskinen, Seppoaccount_box Kratzer, Wolfgangaccount_box Kromhout, Daanaccount_box Kula, Krzysztofaccount_box Kurjata, Pawelaccount_box Kyobutungi, Catherineaccount_box Lachat, Carlaccount_box Laid, Youcefaccount_box Lam, Tai Hingaccount_box Landrove, Orlandoaccount_box Lanska, Veraaccount_box Lappas, Georgaccount_box Laxmaiah, Avulaaccount_box Leclercq, Catherineaccount_box Lee, Jeannetteaccount_box Lee, Jeongheeaccount_box Lehtimaki, Terhoaccount_box Lekhraj, Rampalaccount_box Leon-Munoz, Luz M.account_box Li, Yanpingaccount_box Lim, Wei-Yenaccount_box Lima-Costa, M. 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Jaimeaccount_box Mohamed, Mostafa K.account_box Mohammad, Kazemaccount_box Mohan, Viswanathanaccount_box Yusoff, Muhammad Fadhli Mohdaccount_box Moller, Niels C.account_box Molnar, Denesaccount_box Mondo, Charles K.account_box Moreno, Luis A.account_box Morgan, Karenaccount_box Moschonis, Georgeaccount_box Mossakowska, Malgorzataaccount_box Mostafa, Ayaaccount_box Mota, Jorgeaccount_box Muiesan, Maria L.account_box Muller-Nurasyid, Martinaaccount_box Mursu, Jaakkoaccount_box Nagel, Gabrieleaccount_box Namesna, Janaaccount_box Nang, Ei Ei K.account_box Nangia, Vinay B.account_box Navarrete-Munoz, Eva Mariaaccount_box Ndiaye, Ndeye Coumbaaccount_box Nervi, Flavioaccount_box Nguyen, Nguyen D.account_box Nieto-Martinez, Ramfi S. 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Goyaaccount_box Weerasekera, Deepaaccount_box Whincup, Peter H.account_box Widhalm, Kurtaccount_box Wiecek, Andrzejaccount_box Wilks, Rainford J.account_box Willeit, Johannaccount_box Wojtyniak, Bogdanaccount_box Wong, Tien Yinaccount_box Woo, Jeanaccount_box Woodward, Markaccount_box Wu, Aleksander Giwercmanaccount_box Wu, Frederick C.account_box Wu, Shou Lingaccount_box Xu, Haiquanaccount_box Yang, Xiaoguangaccount_box Ye, Xingwangaccount_box Yoshihara, Akihiroaccount_box Younger-Coleman, Novie O.account_box Zambon, Sabinaaccount_box Zargar, Abdul Hamidaccount_box Zdrojewski, Tomaszaccount_box Zhao, Wenhuaaccount_box Zheng, Yingfeng
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Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions.
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| Autor | Danaei, Goodarz Fahimi, Saman Lu, Yuan Zhou, Bin Hajifathalian, Kaveh Di Cesare, Mariachiara Lo, Wei-Cheng Reis-Santos, Barbara Cowan, Melanie J. Shaw, Jonathan E. Bentham, James Lin, John K. Bixby, Honor Magliano, Dianna Bovet, Pascal Miranda, J. Jaime Khang, Young-Ho Stevens, Gretchen A. Riley, Leanne M. Ali, Mohammed K. Ezzati, Majid Abdeen, Ziad A. Kadir, Khalid Abdul Abu-Rmeileh, Niveen M. Acosta-Cazares, Benjamin Aekplakorn, Wichai Aguilar-Salinas, Carlos A. Ahmadvand, Alireza Al Nsour, Mohannad Alkerwi, Ala'a Amouyel, Philippe Andersen, Lars Bo Anderssen, Sigmund A. Andrade, Dolores S. Anjana, Ranjit Mohan Aounallah-Skhiri, Hajer Aris, Tahir Arlappa, Nimmathota Arveiler, Dominique Assah, Felix K. Avdicova, Maria Balakrishna, Nagalla Bandosz, Piotr Barbagallo, Carlo M. Barcelo, Alberto Batieha, Anwar M. Baur, Louise A. Ben Romdhane, Habiba Bernabe-Ortiz, Antonio Bhargava, Santosh K. Bi, Yufang Bjerregaard, Peter Bjorkelund, Cecilia Blake, Margaret Blokstra, Anneke Bo, Simona Boehm, Bernhard O. Boissonnet, Carlos P. Bovet, Pascal Brajkovich, Imperia Breckenkamp, Juergen Brewster, Lizzy M. Brian, Garry R. Bruno, Graziella Bugge, Anna de Leon, Antonio Cabrera Can, Gunay Candido, Ana Paula C. Capuano, Vincenzo Carvalho, Maria J. Casanueva, Felipe F. Caserta, Carmelo A. Castetbon, Katia Chamukuttan, Snehalatha Chaturvedi, Nishi Chen, Chien-Jen Chen, Fangfang Chen, Shuohua Cheng, Ching-Yu Chetrit, Angela Chiou, Shu-Ti Cho, Yumi Chudek, Jerzy Cifkova, Renata Claessens, Frank Concin, Hans Cooper, Cyrus Cooper, Rachel Costanzo, Simona Cottel, Dominique Cowell, Chris Crujeiras, Ana B. D'Arrigo, Graziella Dallongeville, Jean Dankner, Rachel Dauchet, Luc de Gaetano, Giovanni De Henauw, Stefaan Deepa, Mohan Dehghan, Abbas Dhana, Klodian Di Castelnuovo, Augusto F. Djalalinia, Shirin Doua, Kouamelan Drygas, Wojciech Du, Yong Egbagbe, Eruke E. Eggertsen, Robert El Ati, Jalila Elosua, Roberto Erasmus, Rajiv T. Erem, Cihangir Ergor, Gul Eriksen, Louise la Penaa, Jorge Escobedo-De Fall, Caroline H. Farzadfar, Farshad Felix-Redondo, Francisco J. Ferguson, Trevor S. Fernandez-Berges, Daniel Ferrari, Marika Ferreccio, Catterina Finn, Joseph D. Foger, Bernhard Foo, Leng Huat Fouad, Heba M. Francis, Damian K. Franco, Maria do Carmo Franco, Oscar H. Frontera, Guillermo Furusawa, Takuro Gaciong, Zbigniew Galbarczyk, Andrzej Garnett, Sarah P. Gaspoz, Jean-Michel Gasull, Magda Gates, Louise Geleijnse, Johanna M. Ghasemain, Anoosheh Giampaoli, Simona Gianfagna, Francesco Giovannelli, Jonathan Gross, Marcela Gonzalez Rivas, Juan P. Gonzalez Gorbea, Mariano Bonet Gottrand, Frederic Grant, Janet F. Grodzicki, Tomasz Grontved, Anders Gruden, Grabriella Gu, Dongfeng Guan, Ong Peng Guerrero, Ramiro Guessous, Idris Guimaraes, Andre L. Gutierrez, Laura Hardy, Rebecca Kumar, Rachakulla Hari He, Jiang Heidemann, Christin Hihtaniemi, Ilpo Tapani Ho, Sai Yin Ho, Suzanne C. Hofman, Albert Russo, Andrea R. V. Hormiga, Claudia M. Horta, Bernardo L. Houti, Leila Hussieni, Abdullatif S. Huybrechts, Inge Hwalla, Nahla Iacoviello, Licia Iannone, Anna G. Ibrahim, Mohsen M. Ikeda, Nayu Ikram, M. Arfan Irazola, Vilma E. Islam, Muhammad Iwasaki, Masanori Jacobs, Jeremy M. Jafar, Tazeen Jasienska, Grazyna Jiang, Chao Qiang Jonas, Jost B. Joshi, Pradeep Kafatos, Anthony Kalter-Leibovici, Ofra Kasaeian, Amir Katz, Joanne Kaur, Prabhdeep Kavousi, Maryam Kelishadi, Roya Kengne, Andre P. Kersting, Mathilde Khader, Yousef Saleh Khang, Young-Ho Kiechl, Stefan Kim, Jeongseon Kiyohara, Yutaka Kolsteren, Patrick Korrovits, Paul Koskinen, Seppo Kratzer, Wolfgang Kromhout, Daan Kula, Krzysztof Kurjata, Pawel Kyobutungi, Catherine Lachat, Carl Laid, Youcef Lam, Tai Hing Landrove, Orlando Lanska, Vera Lappas, Georg Laxmaiah, Avula Leclercq, Catherine Lee, Jeannette Lee, Jeonghee Lehtimaki, Terho Lekhraj, Rampal Leon-Munoz, Luz M. Li, Yanping Lim, Wei-Yen Lima-Costa, M. Fernanda Lin, Hsien-Ho Lin, Xu Lissner, Lauren Lorbeer, Roberto Lozano, Jose Eugenio Lundqvist, Annamari Lytsy, Per Ma, Guansheng Machado-Coelho, George L. L. Machi, Suka Maggi, Stefania Magliano, Dianna Makdisse, Marcia Rao, Kodavanti Mallikharjuna Manios, Yannis Manzato, Enzo Margozzini, Paula Marques-Vidal, Pedro Martorell, Reynaldo Masoodi, Shariq R. Matsha, Tandi E. Mbanya, Jean Claude N. McFarlane, Shelly R. McGarvey, Stephen T. McLachlan, Stela McNulty, Breige A. Mediene-Benchekor, Sounnia Meirhaeghe, Aline Menezes, Ana Maria B. Merat, Shahin Meshram, Indrapal I. Mi, Jie Miquel, Juan Francisco Miranda, J. Jaime Mohamed, Mostafa K. Mohammad, Kazem Mohan, Viswanathan Yusoff, Muhammad Fadhli Mohd Moller, Niels C. Molnar, Denes Mondo, Charles K. Moreno, Luis A. Morgan, Karen Moschonis, George Mossakowska, Malgorzata Mostafa, Aya Mota, Jorge Muiesan, Maria L. Muller-Nurasyid, Martina Mursu, Jaakko Nagel, Gabriele Namesna, Jana Nang, Ei Ei K. Nangia, Vinay B. Navarrete-Munoz, Eva Maria Ndiaye, Ndeye Coumba Nervi, Flavio Nguyen, Nguyen D. Nieto-Martinez, Ramfi S. E. Ning, Guang Ninomiya, Toshiharu Noale, Marianna Noto, Davide Ochoa-Aviles, Angelica M. Oh, Kyungwon Onat, Altan Osmond, Clive Otero, Johanna A. Palmieri, Luigi Panda-Jonas, Songhomitra Panza, Francesco Parsaeian, Mahboubeh Peixoto, Sergio Viana Pereira, Alexandre C. Peters, Annette Peykari, Niloofar Pilav, Aida Pitakaka, Freda Piwonska, Aleksandra Piwonski, Jerzy Plans-Rubio, Pedro Porta, Miquel Portegies, Marileen L. P. Poustchi, Hossein Pradeepa, Rajendra Price, Jacqueline F. Punab, Margus Qasrawi, Radwan F. Qorbani, Mostafa Raitakari, Olli Rao, Sudha Ramachandra Ramachandran, Ambady Ramos, Rafel Rampal, Sanjay Rathmann, Wolfgang Redon, Josep Reganit, Paul Ferdinand M. Rigo, Fernando Robinson, Sian M. Robitaille, Cynthia Rodriguez, Laura A. Rodriguez-Artalejo, Fernando Rodriguez-Perez, Maria del Cristo Rojas-Martinez, Rosalba Romaguera, Dora Rosengren, Annika Rubinstein, Adolfo Rui, Ornelas Ruiz-Betancourt, Blanca Sandra Rutkowski, Marcin Sabanayagam, Charumathi Sachdev, Harshpal S. Saidi, Olfa Sakarya, Sibel Salanave, Benoit Salonen, Jukka T. Salvetti, Massimo Sanchez-Abanto, Jose Nunes, Renata Santos, Rute Sardinha, Luis B. Scazufca, Marcia Schargrodsky, Herman Scheidt-Nave, Christa Shaw, Jonathan E. Shibuya, Kenji Shin, Youchan Shiri, Rahman Siantar, Rosalynn Sibai, Abla M. Simon, Mary Simons, Judith Simons, Leon A. Sjostrom, Michael Slowikowska-Hilczer, Jolanta Slusarczyk, Przemyslaw Smeeth, Liam Snijder, Marieke B. Solfrizzi, Vincenzo Sonestedt, Emily Soumare, Aicha Staessen, Jan A. Steene-Johannessen, Jostein Stehle, Peter Stein, Aryeh D. Stessman, Jochanan Stockl, Doris Stokwiszewski, Jakub Strufaldi, Maria Wany Sun, Chien-An Sundstrom, Johan Suriyawongpaisal, Paibul Sy, Rody G. Tai, E. Shyong Tarawneh, Mohammed Tarqui-Mamani, Carolina B. Thijs, Lutgarde Tolstrup, Janne S. Topbas, Murat Torrent, Maties Traissac, Pierre Trinh, Oanh T. H. Tulloch-Reid, Marshall K. Tuomainen, Tomi-Pekka Turley, Maria L. Tzourio, Christophe Ueda, Peter Ukoli, Flora M. Ulmer, Hanno Valdivia, Gonzalo Van Valkengoed, Irene G. M. Vanderschueren, Dirk Vanuzzo, Diego Vega, Tomas Velasquez-Melendez, Gustavo Veronesi, Giovanni Verschuren, Monique Vioque, Jesus Virtanen, Jyrki Visvikis-Siest, Sophie Viswanathan, Bharathi Vollenweider, Peter Voutilainen, Sari Wade, Alisha N. Wagner, Aline Walton, Janette Mohamud, Wan Nazaimoon Wan Wang, Ming-Dong Wang, Ya Xing Wannamethee, S. Goya Weerasekera, Deepa Whincup, Peter H. Widhalm, Kurt Wiecek, Andrzej Wilks, Rainford J. Willeit, Johann Wojtyniak, Bogdan Wong, Tien Yin Woo, Jean Woodward, Mark Wu, Aleksander Giwercman Wu, Frederick C. Wu, Shou Ling Xu, Haiquan Yang, Xiaoguang Ye, Xingwang Yoshihara, Akihiro Younger-Coleman, Novie O. Zambon, Sabina Zargar, Abdul Hamid Zdrojewski, Tomasz Zhao, Wenhua Zheng, Yingfeng |
| Título | Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants |
| Revista | Lancet diabetes & endocrinology |
| ISSN | 2213-8587 |
| ISSN electrónico | 2213-8595 |
| Volumen | 3 |
| Número de publicación | 8 |
| Página inicio | 624 |
| Página final | 637 |
| Fecha de publicación | 2015 |
| Resumen | Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) >= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG >= 7 . 0 mmol/L or 2hOGTT >= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test. |
| Derechos | acceso restringido |
| DOI | 10.1016/S2213-8587(15)00129-1 |
| Enlace | |
| Id de publicación en WoS | WOS:000358540100018 |
| Tema ODS | 03 Good Health and Well-being |
| Tema ODS español | 03 Salud y bienestar |
| Tipo de documento | artículo |