Conclusions HbA1c is neither sensitive nor specific for detecting pre‐diabetes ; fasting glucose is specific but not sensitive .
Interventions in people classified through screening as having pre‐diabetes have some efficacy in preventing or delaying onset of type 2 diabetes in trial population s. As screening is inaccurate , many people will receives an incorrect diagnosis and be referred on for interventions while others will be falsely reassured and not offered the intervention .
These findings suggest that “ screen and treat ” policies alone are unlikely to have substantial impact on the worsening epidemic of type 2 diabetes .
& NA ; Objectives To assess diagnostic accuracy of screening tests for  pre‐diabetes  and efficacy of interventions ( lifestyle or metformin ) in preventing onset of type 2 diabetes in people with pre‐diabetes .
Accuracy of glycated haemoglobin in screening for pre-diabetes in Asian Indians--a community survey: the Chandigarh Urban Diabetes Study (CUDS).
AIM To compare American Diabetes Association and International Expert Committee recommended cut-off values of HbA(1c ) for detecting the presence of pre-diabetes against plasma glucose values obtained from oral glucose tolerance tests in Asian Indians . METHODS A cross-sectional r and omly sample d population survey involving 2368 adults , aged ≥ 20 years .  HbA(1c ) was measured on a Bio-Rad 10 system in 1972 subjects . RESULTS Of the 1972 subjects studied , 329 were detected to have pre-diabetes based on  isolated impaired fasting glucose  in 125 subjects ( 6.3 % ) , isolated impaired glucose tolerance in 141 subjects ( 7.1 % ) and the presence of both in 63 subjects ( 3.2 % ) . The HbA(1c ) cut-off of 34 mmol/mol ( 5.7 % ) , as recommended by the American Diabetes Association for detecting the presence of pre-diabetes , showed sensitivity of 62 % , specificity 77 % , with a positive predictive value of 34.7 % , a negative predictive value of 89.5 % and accuracy of 67.8 % ; whereas the HbA(1c ) cut-off recommended by the International Expert Committee of 42 mmol/mol ( 6 % ) had a sensitivity of 36 % , specificity of 90 % , positive predictive value of 42.7 % , negative predictive of 85.4 % and an accuracy of 77 % . However , both these HbA(1c ) cut-offs underdiagnosed the presence of pre-diabetes in 38 and 64 % of these subjects , respectively . CONCLUSIONS The American Diabetes Association and the International Expert Committee recommended HbA(1c ) cut-off values and oral glucose tolerance tests identify different pre-diabetes cohorts . Long-term prospect i ve studies are required to define the usefulness of one over the other
Conclusions HbA1c is neither sensitive nor specific for detecting pre‐diabetes ; fasting glucose is specific but not sensitive .
Interventions in people classified through screening as having pre‐diabetes have some efficacy in preventing or delaying onset of type 2 diabetes in trial population s. As screening is inaccurate , many people will receives an incorrect diagnosis and be referred on for interventions while others will be falsely reassured and not offered the intervention .
These findings suggest that “ screen and treat ” policies alone are unlikely to have substantial impact on the worsening epidemic of type 2 diabetes .
& NA ; Objectives To assess diagnostic accuracy of screening tests for  pre‐diabetes  and efficacy of interventions ( lifestyle or metformin ) in preventing onset of type 2 diabetes in people with pre‐diabetes .