Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Researchers identify optimal threshold for HbA1c test for prediabetes

The American Diabetes Association recommends hemoglobin A1c (HbA1c) testing as one basis for identifying diabetes and prediabetes.

Setting a specific HbA1c cutoff threshold for prediabetes, which could be used to determine eligibility for interventions to prevent progression to more serious type 2 diabetes, has generated much debate, with at least three different cutoffs recommended by different professional organizations.

A new study led by the Centers for Disease Control and Prevention demonstrates that lowering the cutoff increases the health benefits of preventive interventions, although at higher cost. It concludes that a cutoff level of 5.7% would be cost-effective. The research is published in the April issue of the American Journal of Preventive Medicine.

"Large-scale implementation of evidence-based type 2 diabetes prevention initiatives depends on a clear and efficient strategy to identify individuals at high risk for type 2 diabetes and refer them for intervention. This is the first study to examine the population-level impact and cost effectiveness of using alternative HbA1c cutoffs to determine eligibility for type 2 diabetes preventive interventions," explains lead investigator Xiaohui Zhuo, PhD, from the Division of Diabetes Translation, Centers for Disease Control and Prevention.

The research team used a simulation model to examine the cost effectiveness associated with each progressive 0.1% decrease in the HbA1c cutoff from 6.4% to 5.5% (6.5% is currently the diagnostic cutoff for diabetes). The simulation used the data of nondiabetic American adults from the National Health and Nutritional Examination Survey (NHANES 1999-2006). People identified as having prediabetes were assumed to receive preventive intervention. The study looked at two different interventions: a high cost resource-intensive approach that would cost on average almost $1,000 per year, and a low cost intervention with an annual cost of $300 per year.

Researchers measured the cost per each quality-adjusted life year (QALY), a measure of the quality and quantity of life generated by a medical intervention, at each HbA1c cutoff for both interventions. They found that cutoffs of 5.7% and above were cost effective, based on the conventional $50,000/QALY cost-effectiveness benchmark. Further, the results suggested that the optimal cutoff may be lower if the cost of preventive interventions could be lowered without compromising effectiveness.

Leading clinical and policy-guiding organizations have recommended the HbA1c as an additional diagnostic tool. Its use will likely increase as a screening tool to identify those at high risk for type 2 diabetes. "Therefore, the economic implications of its use need to be well understood. This study will hopefully stimulate more research on the best strategy for optimizing benefits from type 2 diabetes prevention programs at minimum cost," says Dr. Zhuo.

Beverly Lytton | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht Advanced analysis of brain structure shape may track progression to Alzheimer's disease
26.10.2016 | Massachusetts General Hospital

nachricht Indian roadside refuse fires produce toxic rainbow
26.10.2016 | Duke University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Greater Range and Longer Lifetime

26.10.2016 | Power and Electrical Engineering

VDI presents International Bionic Award of the Schauenburg Foundation

26.10.2016 | Awards Funding

3-D-printed magnets

26.10.2016 | Power and Electrical Engineering

More VideoLinks >>>