HbA1c combined with glycated albumin or 1,5-anhydroglucitol improves the efficiency of diabetes screening in a Chinese population

Aims This study aimed to evaluate the ability of HbA(1c) combined with glycated albumin (GA) or 1,5-anhydroglucitol (1,5-AG) to detect diabetes in residents of Jiangsu, China. Methods The oral glucose tolerance test (OGTT) was performed on 2184 people in Jiangsu. HbA(1c), GA, 1,5-AG and other serum biochemical parameters were measured. Receiver operating characteristic curves were plotted to determine the optimal thresholds of HbA(1c), GA and 1,5-AG according to the Youden index. Results (1) The optimal thresholds of HbA(1c), GA and 1,5-AG for the screening of diabetes were >= 45 mmol/mol (6.3%), >= 13.0% and <= 23.0 mu g/ml, respectively. (2) The sensitivities of HbA(1c) combined with GA and 1,5-AG were both 85%, higher than that of HbA(1c) (70%, p < 0.001). Conclusions This study is suitable for cases where plasma glucose is unavailable. Among the residents of Jiangsu, HbA(1c) combined with GA or 1,5-AG can improve the sensitivity of diabetes screening, reduce the miss rate and save the use of OGTT. GA and 1,5-AG are superior in individuals with mild glucose metabolism disorder. GA enhances the detection of diabetes in the nonobese, and 1,5-AG enhances the detection in those with hyperuricaemia.