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Comparison of differing diagnostic criteria for diabetes: experience from a New Zealand community laboratory.
N Z Med J. 1999 Sep 10; 112(1095):339-41.NZ

Abstract

AIMS

To compare rates of diabetes and impaired glucose tolerance in oral glucose tolerance tests (OGTTs) from a New Zealand community laboratory applying differing diagnostic criteria.

METHODS

Results from 455 non-pregnant subjects in 75 g oral glucose tolerance tests were reviewed with diabetes assigned according to 1985 WHO criteria (either fasting plasma glucose (FPG) > or =7.8 mmol/L or two-hour glucose > or =11.1 mmol/L), the American Diabetes Association (ADA) criteria (FPG > or =7.0 mmol/L alone), or revised WHO criteria (adopted by the Australasian Working Party) for OGTT (either FPG > or =7.0 mmol/L or 2-h value of > or =11.1 mmol/L). Impaired glucose tolerance (IGT) was assigned according to 1985 WHO criteria (FPG <7.8 mmol/L and 2-h glucose > or =7.8 mmol but <11.1 mmol/L), impaired fasting glucose (IFG) according to the ADA criteria (FPG of > or =6.1 but <7.0 mmol/L), or combination of IFG and IGT (revised WHO criteria).

RESULTS

The 1985 WHO criteria assigned 266 cases (58.5%) as normal glucose tolerance (NGT), 93 (20.4%) as IGT and 96 (21.1%) as diabetic. The ADA fasting criterion assigned 299 (65.7%) as NGT, 82 (18%) as IFG and 74 (16.2%) as diabetic. Only 55 (47.8%) cases identified as diabetic by either criterion met both. Using the combination of FPG > or =7.0 mmol/L or the 2-h glucose of > or =11.1 mmol/L (revised WHO criteria), 115 (25.3%) were assigned as diabetic, 102 (22.4%) as IFG or IGT, and 238 (52.3%) as NGT.

CONCLUSIONS

There is thus a 22.9% decrease in diabetes with the ADA fasting criterion, compared with the 1985 WHO criteria. With revised WHO criteria (as adopted by the Australasian Working Party), there is a 19.8% increase in diabetes and a 9.7% increase in those with IFG/IGT. These figures have resource implications for the management of diabetes in New Zealand.

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Authors+Show Affiliations

Florkowski C
Southern Community Laboratories, Christchurch. cflorkowski@chmeds.ac.nz
Thompson A
No affiliation info available

MeSH

AdolescentAdultAgedBlood GlucoseClinical Laboratory TechniquesDiabetes Mellitus, Type 2FastingGlucose Tolerance TestHumansMiddle AgedNew Zealand

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10553936

Citation

Florkowski, C, and A Thompson. "Comparison of Differing Diagnostic Criteria for Diabetes: Experience From a New Zealand Community Laboratory." The New Zealand Medical Journal, vol. 112, no. 1095, 1999, pp. 339-41.
Florkowski C, Thompson A. Comparison of differing diagnostic criteria for diabetes: experience from a New Zealand community laboratory. N Z Med J. 1999;112(1095):339-41.
Florkowski, C., & Thompson, A. (1999). Comparison of differing diagnostic criteria for diabetes: experience from a New Zealand community laboratory. The New Zealand Medical Journal, 112(1095), 339-41.
Florkowski C, Thompson A. Comparison of Differing Diagnostic Criteria for Diabetes: Experience From a New Zealand Community Laboratory. N Z Med J. 1999 Sep 10;112(1095):339-41. PubMed PMID: 10553936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of differing diagnostic criteria for diabetes: experience from a New Zealand community laboratory. AU - Florkowski,C, AU - Thompson,A, PY - 1999/11/30/pubmed PY - 1999/11/30/medline PY - 1999/11/30/entrez SP - 339 EP - 41 JF - The New Zealand medical journal JO - N Z Med J VL - 112 IS - 1095 N2 - AIMS: To compare rates of diabetes and impaired glucose tolerance in oral glucose tolerance tests (OGTTs) from a New Zealand community laboratory applying differing diagnostic criteria. METHODS: Results from 455 non-pregnant subjects in 75 g oral glucose tolerance tests were reviewed with diabetes assigned according to 1985 WHO criteria (either fasting plasma glucose (FPG) > or =7.8 mmol/L or two-hour glucose > or =11.1 mmol/L), the American Diabetes Association (ADA) criteria (FPG > or =7.0 mmol/L alone), or revised WHO criteria (adopted by the Australasian Working Party) for OGTT (either FPG > or =7.0 mmol/L or 2-h value of > or =11.1 mmol/L). Impaired glucose tolerance (IGT) was assigned according to 1985 WHO criteria (FPG <7.8 mmol/L and 2-h glucose > or =7.8 mmol but <11.1 mmol/L), impaired fasting glucose (IFG) according to the ADA criteria (FPG of > or =6.1 but <7.0 mmol/L), or combination of IFG and IGT (revised WHO criteria). RESULTS: The 1985 WHO criteria assigned 266 cases (58.5%) as normal glucose tolerance (NGT), 93 (20.4%) as IGT and 96 (21.1%) as diabetic. The ADA fasting criterion assigned 299 (65.7%) as NGT, 82 (18%) as IFG and 74 (16.2%) as diabetic. Only 55 (47.8%) cases identified as diabetic by either criterion met both. Using the combination of FPG > or =7.0 mmol/L or the 2-h glucose of > or =11.1 mmol/L (revised WHO criteria), 115 (25.3%) were assigned as diabetic, 102 (22.4%) as IFG or IGT, and 238 (52.3%) as NGT. CONCLUSIONS: There is thus a 22.9% decrease in diabetes with the ADA fasting criterion, compared with the 1985 WHO criteria. With revised WHO criteria (as adopted by the Australasian Working Party), there is a 19.8% increase in diabetes and a 9.7% increase in those with IFG/IGT. These figures have resource implications for the management of diabetes in New Zealand. SN - 0028-8446 UR - https://www.unboundmedicine.com/medline/citation/10553936/Comparison_of_differing_diagnostic_criteria_for_diabetes:_experience_from_a_New_Zealand_community_laboratory_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -