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ACP Journal Club |18 April 2017

Review: HbA1c has low accuracy for prediabetes; lifestyle programs and metformin reduce progression to T2DM

Dennis G. Maki, MD, MACP

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Barry E, Roberts S, Oke J, et al. Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions. BMJ. 2017;356:i6538. 28052845

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Do screening tests accurately identify prediabetes? In patients identified with prediabetes, what is the effectiveness of interventions to prevent type 2 diabetes?
Included studies compared the diagnostic accuracy of hemoglobin (Hb) A1c or fasting plasma glucose (FPG) tests with the oral glucose tolerance test as the gold standard, and the effectiveness of lifestyle programs or metformin compared with a control group in adults ≥ 18 years of age identified as being at risk for diabetes (impaired glucose tolerance, impaired fasting glucose, increased HbA1c, or history of gestational diabetes) in any setting. Outcomes included sensitivity, specificity, and progression to diabetes.
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Maki DG. Review: HbA1c has low accuracy for prediabetes; lifestyle programs and metformin reduce progression to T2DM. Ann Intern Med. ;166:JC41. doi: 10.7326/ACPJC-2017-166-8-041

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Published: Ann Intern Med. 2017;166(8):JC41.

DOI: 10.7326/ACPJC-2017-166-8-041

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2017 American College of Physicians
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