Tuesday, December 21, 2021

HbA1c Plus FPG May be Superior to FPG Alone in Predicting Diabetes

FPG (fasting plasma glucose), HbA1c, and the OGTT (oral glucose tolerance test) are typically used to determine if someone has prediabetes or diabetes. Indeed, all three measures are employed by the National Diabetes Prevention Program (National DPP) to determine eligibility for the National DPP. So, these blood based tests are important. A recent study focused on HbA1c and FPG to see if the combination of HbA1c plus FPG was a better predictor of  diabetes than FPG. And the researchers indicated that the combination of elevated HbA1c plus elevated Impaired FPG was superior to elevated FPG alone in predicting a progression to diabetes.

The OGTT is considered by some to be the gold standard for diagnosing diabetes and prediabetes. However, it is not always practical to perform the test, and results are not always reproducible. Therefore, while the OGTT may be more accurate in predicting prediabetes than the HbA1c test in some cases, the HbA1c test is widely used since it is more practical and it is considered to be a valid test.

In the above mentioned HbA1c-FPG related study, a meta analysis considered 3011 patients with prediabetes or elevated glucose levels. The researchers concluded that patients with a combination of  elevated FPG and elevated HbA1c had the highest risk of diabetes. And that "Using HbA1c in combination with FPG could identify subgroups of people with IFG [impaired fasting glucose] at highest risk of progression to DM."

While more research is always needed to better predict the progression from prediabetes to diabetes, using the available results of recent studies is a way to create better criteria for determining Diabetes Prevention Program eligibility.

Healthcare providers should pay attention to this study and other studies related to predicting the progression from prediabetes to diabetes. If we can improve our predictive capabilities, this will lead to more bang for the buck, since we will be able to pinpoint and treat the patients who are more likely to progress to diabetes and increase healthcare cost.

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Tags: , , , , bariatric medicine, obesity medicine, medical practice start up, bariatric industry analysis, weight loss industry analysis, weight management industry analysis

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