Racial differences in measures of glycemia in the Vitamin D and Type 2 Diabetes (D2d) Study: a secondary analysis of a randomized trial.
BMJ Open Diabetes Res Care
; 12(1)2024 Feb 12.
Article
em En
| MEDLINE
| ID: mdl-38350671
ABSTRACT
INTRODUCTION:
Understanding how race may influence the association between A1c and glycemia can improve diabetes screening. We sought to determine whether, for a given A1c level, glucose levels during an oral glucose tolerance test (OGTT) differed by race. RESEARCH DESIGN ANDMETHODS:
From data collected at 22 US clinical sites, we conducted a cross-sectional study of concurrently measured A1c and OGTT and observational longitudinal follow-up of the subset with high-risk pre-diabetes. Numerical integration methods were used to calculate area under the glycemic curve (AUCglu) during OGTT and least squares regression model to estimate A1c for a given AUCglu by race, controlling for potential confounders.RESULTS:
1016 black, 2658 white, and 193 Asian persons at risk of diabetes were included in cross-sectional analysis. Of these, 2154 with high-risk pre-diabetes were followed for 2.5 years. For a given A1c level, AUCglu was lower in black versus white participants. After adjustment for potential confounders, A1c levels for a given AUCglu quintile were 0.15-0.20 and 0.02-0.19 percentage points higher in black and Asian compared with white participants, respectively (p<0.05). In longitudinal analyses, black participants were more likely to be diagnosed with diabetes by A1c than white participants (28% vs 10%, respectively; p<0.01). Black and Asian participants were less likely to be diagnosed by fasting glucose than white participants (16% vs 15% vs 37%, respectively; p<0.05). Black participants with A1c levels in the lower-level quintiles had greater increase in A1c over time compared with white participants.CONCLUSIONS:
Use of additional testing beyond A1c to screen for diabetes may better stratify diabetes risk in the diverse US population.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estado Pré-Diabético
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Diabetes Mellitus Tipo 2
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
BMJ Open Diabetes Res Care
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos