Role of Haemoglobin A1C in Diagnosis of Prediabetes in a Sample of Egyptian Population

Background: Prediabetes, typically is defined as blood glucose concentrations higher than normal, but lower than diabetes thresholds, it is a high-risk state for diabetes development. Glycosylated haemoglobin (A1C) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods. The A1C assay provides an accurate, precise measure of chronic glycaemic levels, and correlates with the risk of diabetes complications. Researches had shown differences in A1C among races especially in detection of prediabetic cases. We aimed to assess the incidence of prediabetes in Al-Salhya Al-Gededa city, Al-Sharkia governorate, Egypt and to evaluate the role of A1C in detection of prediabetic patients. Subjects and methods: This was achieved through screening of 550 subjects with high risk factors of diabetes mellitus, (100) subject met criteria of prediabetes were subjected to thorough history taking, full clinical examination and calculation of body mass index, Complete blood picture (CBC), lipid profile and A1C level. Results: 100 (18.2%) 0f the 550 participants were diagnosed to have prediabetes {impaired fasting glucose (IFG) and or impaired glucose tolerance (IGT)}. Using A1C for diagnosis, 49 (9%) were within the prediabetes range (A1C 5.7–6.4%). Overweight was the most frequent risk factor (92%) of the prediabetic patients. There was good correlation between A1C, FBG and PPBG in follow up of prediabetic subjects. However, sensitivity and specificity of A1C in diagnosis of prediabetes was lower in comparison to PPBG (58.2% & 69.7%) alone but was higher when combined with FBG (89.6 % & 69.7%). Conclusion: In conclusion, in Al Salhyia Al Gededa city, Al-Sharkia governorate, Egypt, prediabetes represents a considerable number of cases. A1C is feasible tool for diagnosis of prediabetes however; its specificity is lower than the OGTT needing further studies. Combined A1C, FPG and or PPBG measurement may be the best option to detect prediabetic cases in Arabs regions especially Egypt.