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HbA1c as a Screening tool for Ketosis in Patients with Type 2 Diabetes Mellitus.
Sci Rep. 2016 12 23; 6:39687.SR

Abstract

Ketosis in patients with type 2 diabetes mellitus (T2DM) is overlooked due to atypical symptoms. The objective of this study is to evaluate the value of hemoglobin A1c (HbA1c) as a screening tool for ketosis in T2DM patients. This retrospective study consisted of 253 T2DM patients with ketosis at Shanghai 10th People's Hospital during a period from January 1, 2011 to June 30, 2015. A control group consisted of 221 T2DM patients without ketosis randomly selected from inpatients during the same period. Receiver operating characteristic curve (ROC) analysis was used to examine the sensitivity and specificity of HbA1c as an indicator for ketosis. Higher HbA1c levels were correlated with ketosis. In patients with newly diagnosed T2DM, the area under the curve (AUC) was 0.832, with 95% confidence interval (CI) 0.754-0.911. The optimal threshold was 10.1% (87 mmol/mol). In patients with previously diagnosed T2DM, the AUC was 0.811 (95% CI: 0.767-0.856), with an optimal threshold of 8.6% (70 mmol/mol). HbA1c is a potential screening tool for ketosis in patients with T2DM. Ketosis is much more likely with HbA1c values at ≥10.1% in patients with newly diagnosed T2DM and HbA1c values at ≥8.6% in patients with previously diagnosed T2DM.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.Department of Neurology and Neuroscience, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, United States of America.Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, China.Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, China.Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China. Department of Endocrinology, School of Medicine, Nanjing Medical University, Nanjing, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28009017

Citation

Zhu, Bing, et al. "HbA1c as a Screening Tool for Ketosis in Patients With Type 2 Diabetes Mellitus." Scientific Reports, vol. 6, 2016, p. 39687.
Zhu B, Bu L, Zhang M, et al. HbA1c as a Screening tool for Ketosis in Patients with Type 2 Diabetes Mellitus. Sci Rep. 2016;6:39687.
Zhu, B., Bu, L., Zhang, M., Gusdon, A. M., Zheng, L., Rampersad, S., Li, J., & Qu, S. (2016). HbA1c as a Screening tool for Ketosis in Patients with Type 2 Diabetes Mellitus. Scientific Reports, 6, 39687. https://doi.org/10.1038/srep39687
Zhu B, et al. HbA1c as a Screening Tool for Ketosis in Patients With Type 2 Diabetes Mellitus. Sci Rep. 2016 12 23;6:39687. PubMed PMID: 28009017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HbA1c as a Screening tool for Ketosis in Patients with Type 2 Diabetes Mellitus. AU - Zhu,Bing, AU - Bu,Le, AU - Zhang,Manna, AU - Gusdon,Aaron M, AU - Zheng,Liang, AU - Rampersad,Sharvan, AU - Li,Jue, AU - Qu,Shen, Y1 - 2016/12/23/ PY - 2016/06/16/received PY - 2016/11/25/accepted PY - 2016/12/24/entrez PY - 2016/12/23/pubmed PY - 2018/7/24/medline SP - 39687 EP - 39687 JF - Scientific reports JO - Sci Rep VL - 6 N2 - Ketosis in patients with type 2 diabetes mellitus (T2DM) is overlooked due to atypical symptoms. The objective of this study is to evaluate the value of hemoglobin A1c (HbA1c) as a screening tool for ketosis in T2DM patients. This retrospective study consisted of 253 T2DM patients with ketosis at Shanghai 10th People's Hospital during a period from January 1, 2011 to June 30, 2015. A control group consisted of 221 T2DM patients without ketosis randomly selected from inpatients during the same period. Receiver operating characteristic curve (ROC) analysis was used to examine the sensitivity and specificity of HbA1c as an indicator for ketosis. Higher HbA1c levels were correlated with ketosis. In patients with newly diagnosed T2DM, the area under the curve (AUC) was 0.832, with 95% confidence interval (CI) 0.754-0.911. The optimal threshold was 10.1% (87 mmol/mol). In patients with previously diagnosed T2DM, the AUC was 0.811 (95% CI: 0.767-0.856), with an optimal threshold of 8.6% (70 mmol/mol). HbA1c is a potential screening tool for ketosis in patients with T2DM. Ketosis is much more likely with HbA1c values at ≥10.1% in patients with newly diagnosed T2DM and HbA1c values at ≥8.6% in patients with previously diagnosed T2DM. SN - 2045-2322 UR - https://www.unboundmedicine.com/medline/citation/28009017/HbA1c_as_a_Screening_tool_for_Ketosis_in_Patients_with_Type_2_Diabetes_Mellitus_ L2 - https://doi.org/10.1038/srep39687 DB - PRIME DP - Unbound Medicine ER -