Short-term Variability in Measures of Glycemia and Implications for the Classification of Diabetes

Top Cited Papers
Open Access
Publisher Website
Google Scholar
Abstract
In epidemiologic studies a single glucose measurement is typically used for the classification of diabetes mellitus, often in combination with self-reported diabetes diagnosis status. Guidelines from the American Diabetes Association for the diagnosis of diabetes state that in the absence of “unequivocal hyperglycemia,” a diagnosis of diabetes (typically by measurement of fasting glucose but also by measurement of 2-hour postload glucose) “must be confirmed by repeat testing on a different day.”1(pS46) Thus, short-term variability in fasting glucose, 2-hour glucose, and hemoglobin A1c (HbA1c) measurements has important implications for the diagnosis of diabetes and the conduct and interpretation of epidemiologic studies. The objectives of this study were to characterize the variability in 3 measures of glycemia (fasting glucose, 2-hour glucose, and HbA1c) using repeated measurements and to assess the population-level impact of using repeated measurements for the classification of diabetes and impaired glycemic states.