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Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population
Aim: To find the optimal threshold of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) for diagnosis of diabetes mellitus (DM) and to evaluate the association with diabetic retinopathy (DR) in the South Indian population. Settings and Design: A retrospective population-based study. Metho...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948497/ https://www.ncbi.nlm.nih.gov/pubmed/35371723 http://dx.doi.org/10.7759/cureus.22510 |
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author | Khan, Rehana Surya, Janani Agarwal, Rupesh Sharma, Tarun Raman, Rajiv |
author_facet | Khan, Rehana Surya, Janani Agarwal, Rupesh Sharma, Tarun Raman, Rajiv |
author_sort | Khan, Rehana |
collection | PubMed |
description | Aim: To find the optimal threshold of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) for diagnosis of diabetes mellitus (DM) and to evaluate the association with diabetic retinopathy (DR) in the South Indian population. Settings and Design: A retrospective population-based study. Methods and Materials: A total of 909 newly detected type 2 DM patients were selected from our two previously conducted studies, which include an urban and a rural population of South India. All underwent estimation of fasting, postprandial plasma glucose (PPG), and other biochemical tests. A comprehensive and detailed ophthalmic examination was carried out. The fundi of patients were photographed using 45°, four-field stereoscopic photography. Based on receiver operating characteristic (ROC) curves, sensitivity and specificity were derived. Results: The optimal cut-off values determined by maximizing the sensitivity and specificity of FPG and HbA1c using the Youden index were ≥ 6.17 mmol/L and ≥ 6.3%, respectively. By distributing the cut-off points into deciles and comparing them to the WHO criteria, we found that our HbA1c level of 6.60% was more than the WHO threshold (6.5%), with higher sensitivity (81.6%) and lower specificity (48.3%). The FPG level of 6.80 mmol/L was lower to the WHO criteria (7 mmol/L) with increased sensitivity (77.0%) and lower specificity (45.7%). Prevalence of DR by HbA1c levels between 6.5% and 6.9% was 15.3%. The prevalence of DR was more in the FPG category between 6.4 and 6.9 mmol/L and ≥ 7.5 mmol/L. Conclusion: Our population-based data indicate that for the South Indian population HbA1c value of ≥63 % and FPG value of ≥6.17 mmol/L may be optimal for diagnosing DM with a high level of accuracy and will be useful for the identification of mild and moderate DR. |
format | Online Article Text |
id | pubmed-8948497 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-89484972022-04-01 Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population Khan, Rehana Surya, Janani Agarwal, Rupesh Sharma, Tarun Raman, Rajiv Cureus Endocrinology/Diabetes/Metabolism Aim: To find the optimal threshold of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) for diagnosis of diabetes mellitus (DM) and to evaluate the association with diabetic retinopathy (DR) in the South Indian population. Settings and Design: A retrospective population-based study. Methods and Materials: A total of 909 newly detected type 2 DM patients were selected from our two previously conducted studies, which include an urban and a rural population of South India. All underwent estimation of fasting, postprandial plasma glucose (PPG), and other biochemical tests. A comprehensive and detailed ophthalmic examination was carried out. The fundi of patients were photographed using 45°, four-field stereoscopic photography. Based on receiver operating characteristic (ROC) curves, sensitivity and specificity were derived. Results: The optimal cut-off values determined by maximizing the sensitivity and specificity of FPG and HbA1c using the Youden index were ≥ 6.17 mmol/L and ≥ 6.3%, respectively. By distributing the cut-off points into deciles and comparing them to the WHO criteria, we found that our HbA1c level of 6.60% was more than the WHO threshold (6.5%), with higher sensitivity (81.6%) and lower specificity (48.3%). The FPG level of 6.80 mmol/L was lower to the WHO criteria (7 mmol/L) with increased sensitivity (77.0%) and lower specificity (45.7%). Prevalence of DR by HbA1c levels between 6.5% and 6.9% was 15.3%. The prevalence of DR was more in the FPG category between 6.4 and 6.9 mmol/L and ≥ 7.5 mmol/L. Conclusion: Our population-based data indicate that for the South Indian population HbA1c value of ≥63 % and FPG value of ≥6.17 mmol/L may be optimal for diagnosing DM with a high level of accuracy and will be useful for the identification of mild and moderate DR. Cureus 2022-02-22 /pmc/articles/PMC8948497/ /pubmed/35371723 http://dx.doi.org/10.7759/cureus.22510 Text en Copyright © 2022, Khan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Endocrinology/Diabetes/Metabolism Khan, Rehana Surya, Janani Agarwal, Rupesh Sharma, Tarun Raman, Rajiv Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population |
title | Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population |
title_full | Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population |
title_fullStr | Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population |
title_full_unstemmed | Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population |
title_short | Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population |
title_sort | revised glycemic index for diagnosing and monitoring of diabetes mellitus in south indian population |
topic | Endocrinology/Diabetes/Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948497/ https://www.ncbi.nlm.nih.gov/pubmed/35371723 http://dx.doi.org/10.7759/cureus.22510 |
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