Korean J Intern Med.  2000 Dec;15(3):211-217.

New ADA Criteria in the Korean Population: Fasting Blood Glucose is not Enough for Diagnosis of Mild Diabetes Eespecially in Theelderly

Affiliations
  • 1Endocrinology Section, Catholic Research Institute of Medical Science, Catholic University of Korea, Seoul, Korea.
  • 2Dae-Rim St. Mary's Hospital.

Abstract

BACKGROUND: To compare the 1997 American Diabetes Association (ADA) criteria with the 1985 World Health Organization (WHO) criteria in categorization of the diabetes diagnostic status of Koreans and to define clinical characteristics of subjects diagnosed differently by the two criteria.
METHODS
In 810 Korean subjects, we analyzed blood glucose and insulin response during 75 g oral glucose tolerance test (OGTT). According to current WHO criteria, the cutoff values of FPG which distinguish normal and IGT from diabetes were determined. Then the subjects were categorized according to both WHO and ADA criteria. The clinical characteristics of the subjects with different diagnostic categories by the two criteria were defined.
RESULTS
The FPG cut point distinguishing diabetes from IGT was 117 mg/dl, and from normal was 110 mg/dl. The overall agreement between the ADA criteria and the WHO criteria was moderate, as reflected in the kappa of 0.45. 141 of subjects categorized diabetes by WHO criteria were not diagnosed with ADA criteria. These discordant subjects were older in age and showed blunted early insulin response than concordant normal subjects.
CONCLUSION
These results suggest that mild diabetes by the WHO criteria, especially in the elderly, would not be diagnosed as diabetes by the ADA FPG criteria only. Thus, in a group at high risk for developing diabetes or in a relatively older age group, we should continue using the OGTT.

Keyword

ADA criteria; Glucose tolerance test; fasting plasma glucose

MeSH Terms

Adolescence
Adult
Age Factors
Aged
Blood Glucose/analysis*
Diabetes Mellitus/diagnosis*
Fasting
Female
Human
Male
Middle Age
Retrospective Studies
World Health Organization
Full Text Links
  • KJIM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr