The diagnostic accuracy of HbA , compared to the oral glucose tolerance test, for screening for type 2 diabetes mellitus in Africa-a systematic review and meta-analysis.
Author | Chivese, Tawanda |
Author | Hirst, Jennifer |
Author | Matizanadzo, Joshua T |
Author | Custodio, Michael |
Author | Farmer, Andrew |
Author | Norris, Shane |
Author | Levitt, Naomi |
Available date | 2021-12-12T06:50:13Z |
Publication Date | 2021-12-01 |
Publication Name | Diabetic Medicine |
Identifier | http://dx.doi.org/10.1111/dme.14754 |
Citation | Chivese, T, Hirst, J, Matizanadzo, JT, et al. The diagnostic accuracy of HbA1c, compared to the oral glucose tolerance test, for screening for type 2 diabetes mellitus in Africa-A systematic review and meta-analysis. Diabet Med. 2021; 00:e14754. doi:10.1111/dme.14754 |
ISSN | 0742-3071 |
Abstract | To assess the diagnostic accuracy of HbA , compared to fasting plasma glucose (FPG) and the oral glucose tolerance test (OGTT), in screening for type 2 diabetes (T2D) in Africa. We systematically searched databases for studies that compared the HbA to either the OGTT, or the FPG for T2D diagnosis were included. The QUADAS 2 tool was used for assessing the quality of included studies. We used the split component synthesis (SCS) method for the meta-analysis of diagnostic accuracy studies to pool the studies for meta-analysis of sensitivity and specificity, primarily at the HbA ≥48mmol/mol (6.5%) cut-off and at other cut-offs. We assessed heterogeneity using the I statistic and publication bias using Doi plots. Eleven studies, from seven African countries, with 12925 participants, were included. Against the OGTT, HbA ≥48mmol/mol (6.5%) had a pooled sensitivity of 57.7% (95%CI 43.4-70.9) and specificity of 92.3% (95%CI 83.9 - 96.5). Against the FPG, HbA ≥48mmol/mol (6.5%) had a pooled sensitivity of 64.5% (95%CI 50.5 - 76.4) and specificity of 94.3% (95%CI 87.9 - 97.5). The highest sensitivity for HbA , against the OGTT, was at the 42mmol/mol (6.0%) cut off. In Africa, the HbA ≥48mmol/mol (6.5%) cut-off may miss almost half of the individuals with T2D based on blood glucose measures. |
Language | en |
Publisher | Wiley |
Subject | Africa Type 2 diabetes mellitus diagnostic accuracy glycated haemoglobin A1C sensitivity specificity |
Type | Other |
ESSN | 1464-5491 |
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