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Author Notes:

Correspondence: Manisha Nair, Fogarty International Centre & Centre of Excellence-Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, New Delhi 122002, India; Tel.: +91 11 26850117 (New Delhi)/+44 7405744536 (Oxford, England); Email: dr.manisha.das@gmail.com

Disclosures: The authors state that there are no conflicts of interest with regards to this study.


Research Funding:

Funded by NIH.


  • HbA1c
  • Diabetes
  • “Asian Indians”

HbA1c Values for Defining Diabetes and Impaired Fasting Glucose in Asian Indians

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Journal Title:

Primary Care Diabetes


Volume 5, Number 2


, Pages 95-102

Type of Work:

Article | Post-print: After Peer Review


Aim To determine the glycosylated haemoglobin (HbA1c) cut-points for diabetes and impaired fasting glucose (IFG) among Asian Indians. Methods Participants (n = 525) were a random sample selected from the India Health Study. Based on history and fasting plasma glucose (FPG), participants were classified into known diabetes, newly diagnosed diabetes (NDD), impaired fasting glucose (IFG) [ADA and WHO criteria] or normal fasting glucose (NFG). Receiver Operating Characteristic curves were used to identify the optimum sensitivity and specificity for defining HbA1c cut-points for NDD and IFG against the FPG criteria. Results There were 64 participants with a known history of diabetes. Of the remaining 461, IFG was present in 44.7% (ADA) and 18.2% (WHO), and 10.4% were NDD. Mean HbA1c were 5.4 (±0.04)% for NFG; 5.7 (±0.06)% among IFG-ADA, 5.8 (±0.09)% among IFG-WHO; 7.5 (±0.33)% for NDD and 8.4 (±0.32)% for known diabetes. Optimal HbA1c cut-point for NDD was 5.8% (sensitivity = 75%, specificity = 75.5%, AUC = 0.819). Cut-point for IFG (ADA) was 5.5% (sensitivity = 59.7%, specificity = 59.9%, AUC = 0.628) and for IFG (WHO) was 5.6% (sensitivity = 60.7%, specificity = 65.1%, AUC = 0.671). Conclusion In this study population from north and south regions of India, the HbA1c cut-point that defines NDD (≥5.8%) was much lower than that proposed by an international expert committee and the American Diabetes Association (≥6.5%). A cut-point of ≥5.5% or ≥5.6% defined IFG, and was slightly lower than the ≥5.7% for high risk proposed, but accuracy was less than 70%.

Copyright information:

© 2011 Elsevier Ltd. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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