Fasting criteria for screening: test properties and agreement with glucose tolerance

Mark Daniel, Kevin G. Rowley, Kerin O'Dea

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The objective of this study was to characterise test properties and agreement for fasting glucose cut-offs used for screening diabetes in Indigenous Australian communities, across a range of diabetes prevalence. The oral glucose tolerance test (OGTT) was administered to adult volunteers (n=3249) for community-based diabetes screening in isolated settlements (n=25). Two-hour post-load glucose concentration was the 'gold standard' against which test properties were characterised for fasting plasma glucose cut-offs at concentrations of ≥7.0 mmol/l (ADA criterion) and ≥7.8 mmol/l (WHO criterion). Test sensitivity (95% CI) was greater for the ADA (72.5%, 67.4-77.1%) versus the WHO criterion (61.5%, 56.1-66.6%). Specificity was high (>98%) using either criterion. The post-test likelihood of diabetes, given a population prevalence of 14.8%, was 89.1% using the ADA criterion, and 94.9% using the WHO criterion. The ADA criterion gave better agreement than did the WHO criterion for diabetes prevalence ≥8.6%, and the probability of false results was lower using the ADA criterion, when diabetes prevalence was ≥12.8%. According to the ADA criterion most individuals ascribed false negative results were aged ≥35 years, overweight/obese, or had impaired fasting glucose. The fasting glucose criterion of 7.0 mmol/l was superior to 7.8 mmol/l in screening for diabetes.

Original languageEnglish
Pages (from-to)139-148
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume58
Issue number2
DOIs
Publication statusPublished - Nov 2002
Externally publishedYes

Fingerprint

Fasting
Glucose
Glucose Tolerance Test
Volunteers
Population

Cite this

@article{0c44554f549b4e5a8241f0d6856b863a,
title = "Fasting criteria for screening: test properties and agreement with glucose tolerance",
abstract = "The objective of this study was to characterise test properties and agreement for fasting glucose cut-offs used for screening diabetes in Indigenous Australian communities, across a range of diabetes prevalence. The oral glucose tolerance test (OGTT) was administered to adult volunteers (n=3249) for community-based diabetes screening in isolated settlements (n=25). Two-hour post-load glucose concentration was the 'gold standard' against which test properties were characterised for fasting plasma glucose cut-offs at concentrations of ≥7.0 mmol/l (ADA criterion) and ≥7.8 mmol/l (WHO criterion). Test sensitivity (95{\%} CI) was greater for the ADA (72.5{\%}, 67.4-77.1{\%}) versus the WHO criterion (61.5{\%}, 56.1-66.6{\%}). Specificity was high (>98{\%}) using either criterion. The post-test likelihood of diabetes, given a population prevalence of 14.8{\%}, was 89.1{\%} using the ADA criterion, and 94.9{\%} using the WHO criterion. The ADA criterion gave better agreement than did the WHO criterion for diabetes prevalence ≥8.6{\%}, and the probability of false results was lower using the ADA criterion, when diabetes prevalence was ≥12.8{\%}. According to the ADA criterion most individuals ascribed false negative results were aged ≥35 years, overweight/obese, or had impaired fasting glucose. The fasting glucose criterion of 7.0 mmol/l was superior to 7.8 mmol/l in screening for diabetes.",
keywords = "American Diabetes Association (ADA), Australia, Diabetes mellitus, Diagnostic criteria, Indigenous, Screening, Tests, World Health Organisation (WHO)",
author = "Mark Daniel and Rowley, {Kevin G.} and Kerin O'Dea",
year = "2002",
month = "11",
doi = "10.1016/S0168-8227(02)00133-X",
language = "English",
volume = "58",
pages = "139--148",
journal = "Diabetes Research and Clinical Practice",
issn = "0168-8227",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

Fasting criteria for screening: test properties and agreement with glucose tolerance. / Daniel, Mark; Rowley, Kevin G.; O'Dea, Kerin.

In: Diabetes Research and Clinical Practice, Vol. 58, No. 2, 11.2002, p. 139-148.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Fasting criteria for screening: test properties and agreement with glucose tolerance

AU - Daniel, Mark

AU - Rowley, Kevin G.

AU - O'Dea, Kerin

PY - 2002/11

Y1 - 2002/11

N2 - The objective of this study was to characterise test properties and agreement for fasting glucose cut-offs used for screening diabetes in Indigenous Australian communities, across a range of diabetes prevalence. The oral glucose tolerance test (OGTT) was administered to adult volunteers (n=3249) for community-based diabetes screening in isolated settlements (n=25). Two-hour post-load glucose concentration was the 'gold standard' against which test properties were characterised for fasting plasma glucose cut-offs at concentrations of ≥7.0 mmol/l (ADA criterion) and ≥7.8 mmol/l (WHO criterion). Test sensitivity (95% CI) was greater for the ADA (72.5%, 67.4-77.1%) versus the WHO criterion (61.5%, 56.1-66.6%). Specificity was high (>98%) using either criterion. The post-test likelihood of diabetes, given a population prevalence of 14.8%, was 89.1% using the ADA criterion, and 94.9% using the WHO criterion. The ADA criterion gave better agreement than did the WHO criterion for diabetes prevalence ≥8.6%, and the probability of false results was lower using the ADA criterion, when diabetes prevalence was ≥12.8%. According to the ADA criterion most individuals ascribed false negative results were aged ≥35 years, overweight/obese, or had impaired fasting glucose. The fasting glucose criterion of 7.0 mmol/l was superior to 7.8 mmol/l in screening for diabetes.

AB - The objective of this study was to characterise test properties and agreement for fasting glucose cut-offs used for screening diabetes in Indigenous Australian communities, across a range of diabetes prevalence. The oral glucose tolerance test (OGTT) was administered to adult volunteers (n=3249) for community-based diabetes screening in isolated settlements (n=25). Two-hour post-load glucose concentration was the 'gold standard' against which test properties were characterised for fasting plasma glucose cut-offs at concentrations of ≥7.0 mmol/l (ADA criterion) and ≥7.8 mmol/l (WHO criterion). Test sensitivity (95% CI) was greater for the ADA (72.5%, 67.4-77.1%) versus the WHO criterion (61.5%, 56.1-66.6%). Specificity was high (>98%) using either criterion. The post-test likelihood of diabetes, given a population prevalence of 14.8%, was 89.1% using the ADA criterion, and 94.9% using the WHO criterion. The ADA criterion gave better agreement than did the WHO criterion for diabetes prevalence ≥8.6%, and the probability of false results was lower using the ADA criterion, when diabetes prevalence was ≥12.8%. According to the ADA criterion most individuals ascribed false negative results were aged ≥35 years, overweight/obese, or had impaired fasting glucose. The fasting glucose criterion of 7.0 mmol/l was superior to 7.8 mmol/l in screening for diabetes.

KW - American Diabetes Association (ADA)

KW - Australia

KW - Diabetes mellitus

KW - Diagnostic criteria

KW - Indigenous

KW - Screening

KW - Tests

KW - World Health Organisation (WHO)

UR - http://www.scopus.com/inward/record.url?scp=0036836783&partnerID=8YFLogxK

U2 - 10.1016/S0168-8227(02)00133-X

DO - 10.1016/S0168-8227(02)00133-X

M3 - Article

VL - 58

SP - 139

EP - 148

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

IS - 2

ER -