A1c test misses many diabetes diagnosis frequently

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A1c test misses many cases of diabetes


Using the hemoglobin A1c blood test to diagnose diabetes tends to underestimate the prevalence of the disease, according to a new study to be presented Saturday, March 23 at ENDO 2019, the Endocrine Society's annual meeting in New Orleans, La.


The new study included 9,000 adults without a diabetes diagnosis. The participants got both an A1c test and an oral tolerance glucose test, and the researchers compared the results. The researchers found the A1c test didn't catch 73 percent of diabetes cases that were detected by the oral glucose test. "The A1c test said these people had normal glucose levels when they didn't," Chang Villacreses said.


The researchers also found race and ethnicity had a significant impact on the accuracy of A1c. It was more likely to detect abnormal glucose levels in non-Hispanic whites than in non-Hispanic blacks or Hispanics.


"Our results indicated that the prevalence of diabetes and normal glucose tolerance defined solely by A1c is highly unreliable, with a significant tendency for underestimation of the prevalence of diabetes and overestimation of normal glucose tolerance," Chang Villacreses said.
 
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