Two in One: Diagnosing Type 2 Diabetes With Single-Sample Testing
Authors: K. M. Venkat Narayan, Ram Jagannathan
Journal: Annals of Internal Medicine (2018)

Editorials7 August 2018Two in One: Diagnosing Type 2 Diabetes With Single-Sample TestingK. M. Venkat Narayan, MD, MSc, MBA and Ram Jagannathan, PhDK. M. Venkat Narayan, MD, MSc, MBAEmory University, Atlanta, Georgia (K.M.N., R.J.)Search for more papers by this author and Ram Jagannathan, PhDEmory University, Atlanta, Georgia (K.M.N., R.J.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1477 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The accuracy of type 2 diabetes diagnosis is important for optimal clinical care. Expert bodies, including the American Diabetes Association and the World Health Organization, recommend basing the diagnosis on 1 of 3 measures of glycemia: hemoglobin A1c (HbA1c) level, fasting glucose level, or 2-hour plasma glucose level after an oral glucose tolerance test (1–3). Recommendations advocate repeated testing within a “short period of time” to confirm the diagnosis (1–3), with the goal of reducing the probability of a false-positive diagnosis. The American Diabetes Association has not expressed a preference for the choice of confirmatory test; however, it recommends that ...References1. American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33 Suppl 1:S11-61. [PMID: 20042772] doi:10.2337/dc10-S011 CrossrefMedlineGoogle Scholar2. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327-34. [PMID: 19502545] doi:10.2337/dc09-9033 CrossrefMedlineGoogle Scholar3. World Health Organization. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus: Abbreviated Report of a WHO Consultation. WHO/NMH/CHP/CPM/11.1. Geneva: World Health Organization; 2011. Google Scholar4. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2018. Diabetes Care. 2018;41:S13-S27. [PMID: 29222373] doi:10.2337/dc18-S002 CrossrefMedlineGoogle Scholar5. Selvin E, Wang D, Matsushita K, Grams ME, Coresh J. Prognostic implications of single-sample confirmatory testing for undiagnosed diabetes. A prospective cohort study. Ann Intern Med. 2018;169:156-64. doi:10.7326/M18-0091 LinkGoogle Scholar6. Selvin E, Crainiceanu CM, Brancati FL, Coresh J. Short-term variability in measures of glycemia and implications for the classification of diabetes. Arch Intern Med. 2007;167:1545-51. [PMID: 17646610] CrossrefMedlineGoogle Scholar7. Siu AL; U.S. Preventive Services Task Force. Screening for abnormal blood glucose and type 2 diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:861-8. [PMID: 26501513]. doi:10.7326/M15-2345 LinkGoogle Scholar8. Narayan KM, Gujral UP. Evidence tips the scale toward screening for hyperglycemia. Diabetes Care. 2015;38:1399-401. [PMID: 26207050] doi:10.2337/dc15-0856 CrossrefMedlineGoogle Scholar9. American Diabetes Association. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018;41:917-28. [PMID: 29567642] doi:10.2337/dci18-0007 CrossrefMedlineGoogle Scholar10. Thorpe KE, Ogden LL, Galactionova K. Chronic conditions account for rise in Medicare spending from 1987 to 2006. Health Aff (Millwood). 2010;29:718-24. [PMID: 20167626] doi:10.1377/hlthaff.2009.0474 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Emory University, Atlanta, Georgia (K.M.N., R.J.)Grant Support: Dr. Narayan was partially supported by grant P30DK111024 from the National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Jagannathan was supported by grant R01HL125442 from the National Heart, Lung, and Blood Institute, National Institutes of Health.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1477.Corresponding Author: K.M. Venkat Narayan, MD, MSc, MBA, Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322; e-mail, [email protected]edu.Current Author Addresses: Drs. Narayan and Jagannathan: Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322.This article was published at Annals.org on 19 June 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrognostic Implications of Single-Sample Confirmatory Testing for Undiagnosed Diabetes Elizabeth Selvin , Dan Wang , Kunihiro Matsushita , Morgan E. Grams , and Josef Coresh Metrics 7 August 2018Volume 169, Issue 3Page: 193-194KeywordsBloodGlobal healthGlucoseHbA1cHemoglobinProspective studiesRenal diseasesRisk managementSpecificityType 2 diabetes ePublished: 19 June 2018 Issue Published: 7 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...