Hemoglobin A<sub>1c</sub>Diagnostic Cutoff Differences Between Black and White Persons
Authors: Yusuke Tsugawa, Kenneth J. Mukamal, Christina C. Wee
Journal: Annals of Internal Medicine (2013)

Letters1 January 2013Hemoglobin A1c Diagnostic Cutoff Differences Between Black and White PersonsYusuke Tsugawa, MD, MPH, Kenneth J. Mukamal, MD, MPH, and Christina C. Wee, MD, MPHYusuke Tsugawa, MD, MPHFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this author, Kenneth J. Mukamal, MD, MPHFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this author, and Christina C. Wee, MD, MPHFrom Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-1-201301010-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Dagogo-Jack for his comments. We agree that the design of our study has important limitations—many of which we acknowledged in the paper—and that our results must be interpreted cautiously. Our main conclusion was that our findings do not support increasing the diagnostic threshold of HbA1c in black persons, given that HbA1c values seem higher in black persons than in white persons (1). Although our study did suggest the possibility that the risk for retinopathy begins to increase at lower HbA1c levels in black persons than in white persons, we were careful not to overinterpret these ...References1. Ziemer DC, Kolm P, Weintraub WS, Vaccarino V, Rhee MK, Twombly JG, et al; Glucose-independent. black-white differences in hemoglobin A1c levels: a cross-sectional analysis of 2 studies. Ann Intern Med. 2010;152:770-7. [PMID: 20547905] LinkGoogle Scholar2. Selvin E, Steffes MW, Ballantyne CM, Hoogeveen RC, Coresh J, Brancati FL. Racial differences in glycemic markers: a cross-sectional analysis of community-based data. Ann Intern Med. 2011;154:303-9. [PMID: 21357907] LinkGoogle Scholar3. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183-97. [PMID: 9203460] Google Scholar4. Tsugawa Y, Takahashi O, Meigs JB, Davis RB, Imamura F, Fukui T, et al. New diabetes diagnostic threshold of hemoglobin A1c and the 3-year incidence of retinopathy. Diabetes. 2012;:. [PMID: 22891221] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Yusuke Tsugawa, MD, MPH; Kenneth J. Mukamal, MD, MPH; Christina C. Wee, MD, MPHAffiliations: From Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2083. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoShould the Hemoglobin A1c Diagnostic Cutoff Differ Between Blacks and Whites? Yusuke Tsugawa , Kenneth J. Mukamal , Roger B. Davis , William C. Taylor , and Christina C. Wee Hemoglobin A1c Diagnostic Cutoff Differences Between Black and White Persons Samuel Dagogo-Jack Metrics Cited byDiagnostic performance of glycated hemoglobin for diabetic retinopathy in non-diabetic older overweight/obese African-Americans 1 January 2013Volume 158, Issue 1Page: 73-74KeywordsConflicts of interestDiabetic retinopathyDisclosureForecastingGlucoseHbA1cHemoglobinLesionsLongitudinal studiesRetinopathy ePublished: 1 January 2013 Issue Published: 1 January 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...