Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Researchers identify optimal threshold for HbA1c test for prediabetes

13.03.2012
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:
http://www.ucsd.edu

More articles from Health and Medicine:

nachricht Indications of Psychosis Appear in Cortical Folding
26.04.2018 | Universität Basel

nachricht GLUT5 fluorescent probe fingerprints cancer cells
20.04.2018 | Michigan Technological 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: Why we need erasable MRI scans

New technology could allow an MRI contrast agent to 'blink off,' helping doctors diagnose disease

Magnetic resonance imaging, or MRI, is a widely used medical tool for taking pictures of the insides of our body. One way to make MRI scans easier to read is...

Im Focus: BAM@Hannover Messe: innovative 3D printing method for space flight

At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.

Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...

Im Focus: Molecules Brilliantly Illuminated

Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.

Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...

Im Focus: Spider silk key to new bone-fixing composite

University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.

Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.

Im Focus: Writing and deleting magnets with lasers

Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.

Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

IWOLIA: A conference bringing together German Industrie 4.0 and French Industrie du Futur

09.04.2018 | Event News

 
Latest News

World's smallest optical implantable biodevice

26.04.2018 | Power and Electrical Engineering

Molecular evolution: How the building blocks of life may form in space

26.04.2018 | Life Sciences

First Li-Fi-product with technology from Fraunhofer HHI launched in Japan

26.04.2018 | Power and Electrical Engineering

VideoLinks
Science & Research
Overview of more VideoLinks >>>