What is the gold-standard test for diabetes

Posted by Jack on December 6, 2022

Several medical professionals have expressed concern over the gold standard test for diabetes, which is the HbA1c. As a result, the American Diabetes Association recently announced the development of a new test, known as the TIR, which will better measure the chemistry of blood sugar in a patient's bloodstream. It will also allow doctors to make more accurate diagnoses and treatment decisions.


OGTT is considered the gold-standard test for diabetes. It is used to measure glucose tolerance during a 2-hour period. It has the potential to detect type 2 diabetes as well as prediabetes. However, the OGTT has low reproducibility. This has hampered physicians' decision to use it routinely. In fact, it may be less accurate than other tests. In order to evaluate the performance of OGTT as a diagnostic tool for DM, a cross-sectional study was conducted in three public primary care clinics in Hong Kong.

A total of 392 participants were recruited. All were given a standardized questionnaire. The clinical characteristics of these subjects were compared using one-way ANOVA. Then, the relationship between HbA1c and OGTT was evaluated. In addition, Cohen's kappa coefficients were used to determine the agreement between the two tests.

For assessing the accuracy of DM diagnosis, OGTT and HbA1c were compared using the receiver operating characteristic (ROC) curve. The best measure of sensitivity and specificity was the area under the curve (AUC) (I0-120)/AUC (G0-120). These two measures showed the highest correlation coefficients with the gold standard measures. Using the ROC curve, an optimal cut-off threshold was determined.

The optimal cut-off value was 6.3%. The AUC of HbA1c was 0.65. The performance of HbA1c was evaluated in four dimensions: sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). The highest positive predictive value was 84.6% and the highest negative predictive value was 22.8%.

Prevalence of DM was higher in cases that were confirmed by HbA1c than in those that were not. These cases were more likely to have higher fasting glucose and higher triglyceride levels. However, they had lower HDL-C levels. These results are directly relevant to clinical practice.

The optimal cut-off value for DM diagnosis using OGTT was 6.3%. This threshold is superior to those used in the Chinese general population. The cut-off value was also consistent with other Chinese studies. It should be used for confirmation of DM in Chinese patients with IFG.

It is important to detect DM early. This can help prevent future cardiovascular disease and diabetes complications. Therefore, a prospective follow-up study should be conducted to evaluate the approach to OGTT and HbA1c in high-risk patients.


OGTT (oral glucose tolerance test) and HbA1c (glycated haemoglobin) are the gold standard tests for diagnosing diabetes mellitus. They are both performed after a person has fasted for 8 to 12 hours. They are used to detect diabetes mellitus, dysglycemia, and impaired glucose tolerance. OGTT has become more useful over time as it provides a better measure of glucose intolerance. However, OGTT is cumbersome and requires a stable diet. It remains the gold standard for identifying diabetes mellitus in patients after renal transplantation.

An 11-year retrospective cross-sectional study of high-risk Thai patients who underwent an OGTT between 2007 and 2017 was conducted. This study evaluated the accuracy of the HbA1c test in detecting diabetes mellitus and vascular disease risk. Among 831 participants, 134 had a HbA1c > =6.5%.

In the study, participants were divided into three groups based on the OGTT criteria. A second test was performed if the first test showed hyperglycemia. In addition, participants were followed up for major cardiovascular events until 2017. During 4.1 years of follow-up, HbA1c measurements were performed. All statistical analyses were conducted using Statistical Package for the Social Sciences version 22.0.

There were significant differences in HbA1c concentrations between the different ethnic groups. Hispanics and African-Americans had higher concentrations. This study also showed that HbA1c concentrations increased at a rate of 0.1% per decade after 30 years of age. However, there was a large attenuation in HRs for known diabetes after adjustment for modifiable vascular risk factors.

The study demonstrated that a high cut-off value for HbA1c was necessary to diagnose DM. The optimal cut-off value was 6.3 percent. This was calculated using a receiver operating characteristic (ROC) curve. The optimal cut-off value was compared with the cut-off values used in previous Chinese studies.

A prospective follow-up study should be conducted to evaluate the approach used for OGTT and HbA1c in high-risk patients. A prospective study should also evaluate the long-term risk of cardiovascular complications in patients with diabetes. The study also assessed whether HbA1c levels were associated with cardiovascular risk in patients with chronic kidney disease.


Among the various diabetes control measures, Time in Range (TIR) is the gold standard. It measures the time spent in the glucose target range over a 24-hour period.

Various studies have examined the association between TIR and other important diabetes markers. However, it is important to note that TIR is not a substitute for a test such as HbA1c. It can provide complementary information about glucose control, and has been shown to have a number of other significant benefits.

TIR is not only important in predicting long-term diabetes complications, but it is also useful for assessing glucose variability. For instance, each 5% increase in TIR is associated with clinically meaningful benefits. It is also a good measure of how stable a person's glucose control is, although it may not be a perfect indicator of how well a person is controlling their diabetes.

For some people with diabetes, TIR is a way to measure the impact of lifestyle changes, such as taking more exercise after lunch. In addition, it is a way to better understand the effect of meals, snacks, and insulin on glucose levels. It can also be used to track how quickly a person reaches a target glucose range.

It is also an indicator of a person's quality of life. It can predict the risk of developing complications such as kidney disease. A higher time in range is also associated with better mood, less stress, and less stomach aches. However, TIR is only useful if it is used in conjunction with another diabetes indicator, such as a measurement of time spent in hypoglycaemia.

It may be worth discussing your TIR goals with your healthcare provider. This will help to ensure that you are taking the appropriate steps to manage your diabetes. It can also provide a guide for making medication adjustments. However, it is important to note that there are no universal TIR targets, and each person has a different glucose range.

In fact, it is important to discuss your TIR goals with your healthcare provider, especially if you are pregnant or at high risk of developing complications.


Using an oral glucose tolerance test (OGTT) to diagnose diabetes is a gold standard. The test is based on two hours of blood glucose monitoring after a 75-gram oral glucose load. The result is then compared with HbA1c to identify if the patient is diabetic or not. A repeat test is recommended if the first test is inconclusive. However, the results of an OGTT may be variable and there is no guarantee that two tests will detect the same individual.

While OGTT is considered a gold standard test for diagnosing diabetes, it is not the only test that can be used to diagnose the disease. The HbA1c test, for example, is now considered the diagnostic test for diabetes in the United States. In 2010, the American Diabetes Association (ADA) adopted the use of the HbA1c test as the gold standard for diagnosing diabetes. In 2011, the WHO officially adopted the use of the HbA1c as the diagnostic test for diabetes.

The HbA1c test is an indirect measure of the average blood glucose levels of an individual in the past three months. HbA1c values increase with age and are also influenced by physiological factors. For example, an iron deficiency increases glycation and may cause an elevated HbA1c. In addition, hemoglobinopathies such as sickle cell disease, erythropoietin therapy, and pregnancy are known to increase red cell turnover.

HbA1c may be used to diagnose diabetes in adolescents. However, some studies question the validity of using the test in this age group. For instance, the American Diabetes Association acknowledges limited data supporting the use of the test in children. However, they continue to recommend the use of the test in children.

The use of the OGTT to detect diabetes has been shown to be more accurate than the A1C. However, it is less reliable than other diagnostic tests and is more susceptible to errors. It is also cumbersome. For this reason, some providers may want to use the A1C test as a screening test.

The American Diabetes Association has also recommended the use of the HbA1c in adults. However, the use of the test is not recommended for diagnosing diabetes in children.

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