Evaluation of the diagnostic efficacy of different glycemic markers and insulin indices for diabetes mellitus in a general population

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Abstract
We aimed to assess the contribution of repeated fasting blood glucose (FBG) measurements along with single collection of 2-hour postprandial glucose (2h PG) and glycated hemoglobin (HbA1c) on diabetes mellitus (DM) prevalence estimation, and investigate the association between the insulin-related markers and DM risk in a southeastern Chinese population. We included 6515 participants aged 35-75 years with complete glycemic data. McNemar's test was utilized to compare the difference between WHO and ADA criteria in DM diagnosis. Newly diagnosed DM cases were classified as 1defect (DEF), 2DEF, or 3DEF DM according to the abnormalities of three glycemic indices. The sensitivity and specificity of diagnosing DM using different glycemic markers were assessed. The association between different index and DM was analyzed using log-binomial regression and receiver operating characteristic curves. The age- and sex-standardized prevalence of DM was 14.0% and 14.7% by the WHO and ADA criteria, respectively. 2h PG, HbA1c, and FBG detected 89.65%, 40.69%, and 15.24% of newly diagnosed DM population, respectively. . All cases identified by repeated FBG were also detected by either 2h PG or HbA1c. The disposition index showed the highest area under the curve (0.82) in DM prediction, followed by the product of triglyceride and fasting glucose (TyG, 0.72). The estimated previous diagnosis, treatment, and control rate of DM was 38.6%, 34.9%, and 29.4%, respectively. It is recommended that 2h PG and HbA1c should be used in population-based studies. The disposition index and TyG could potentially be used as DM predictors.
Funding Information
  • National Key R&D Program of China (No.2024YFC3405800 and No.2024YFC3405803)
  • National Natural Science Foundation of China (No. 82103923 and No. 82204023)
  • Government of Fuqing city (019B003)
  • Fujian Provincial Department of Science and Technology (No.2019Y9021 and No. 019L3006)

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