AlC and Diabetes Diagnosis Among Filipino Americans, Japanese Americans, and Native Hawaiians

OBJECTIVE - To examine the sensitivity and specificity of AlC >= 6 5% to diagnose diabetes among Filipino Americans Japanese Americans and Native Hawaiians RESEARCH DESIGN AND METHODS - This was a cross sectional study among middle-aged adults without prior diagnosis of type 2 diabetes who completed a 2-h 75-g oral glucose tolerance test (OGTT) and AlC measures RESULTS - The 933 participants had a mean age of 54 2 years and 73% were women A total of 425 (45 5%) subjects had impaired fasting glucose or impaired glucose tolerance 145 (15 5%) had type 2 diabetes (by OGTT) and 83 (8 9%) had AlC >= 6 5% The sensitivity and specificity of AlC >= 6 5% to define diabetes (by OGTT) was 40 0 and 96 8% and 68 9 and 95 3% respectively (by fasting plasma glucose only) However, (64 8%) of Filipino and Japanese subjects with diabetes had isolated postchallenge hyperglycemia AlC >= 6 5% sensitivity and specificity was 19 1 and 92 1% respectively to define isolated postchallenge hyperglycemia in the total sample CONCLUSIONS - AlC >= 6 5% had low sensitivity and may delay diagnosis of type 2 diabetes without OGTT This limitation is exacerbated by isolated postchallenge hyperglycemia in Asian Americans