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. 2001 Jun 15;28(1):17-22.
doi: 10.1016/s0212-6567(01)78890-7.

[Do the new criteria of the American Diabetes Association lead to earlier diagnosis of type-2 diabetes mellitus?]

[Article in Spanish]
M Mata Cases  1 , X Cos Claramunt, E Pujol Ribera, I Bobé Molina, R Centelles Fernández, R Ortiz López, A Ramos Fuertes, C Royo Pastor
Affiliations

[Do the new criteria of the American Diabetes Association lead to earlier diagnosis of type-2 diabetes mellitus?]

[Article in Spanish]
M Mata Cases et al. Aten Primaria. .

Abstract
in English, Spanish

Objective: To analyze the period of time between the first occasional fasting hyperglycaemia (OFH) and the diagnosis of type 2 diabetes mellitus (DM2), using the World Health Organization (WHO) criteria or the American Diabetes Association (ADA) criteria.

Design: Retrospective, observational study.

Setting: Urban primary care centre.

Subjects: 104 patients with DM2 diagnosed between 1991 and 1995 who had a previous OFH.

Measurements: Age, gender and other risk factors, dates of the first OFH (fasting plasma glucose >= 110 mg/dl), the diagnosis according to WHO criteria (2 fasting plasma glucose >= 140 mg/dl or >= 200 mg/dl two hours after the oral glucose test tolerance (OGTT)) or with the ADA criteria (2 fasting plasma glucose >= 126 mg/dl), and the intervals in months between them.

Results: Of the 222 diagnosed patients, 104 (47%) had previous OFH. Age at diagnosis was 60.8 (SD 10.1) and 53% were women. OGTT was performed in 51 cases (49%). The median (range) of the interval between the first OFH and diagnosis was 16 months (0-101) for those who were undertaken an OGTT, and 45 months (1-104) for those who were not (p = 0.003). In these last ones, ADA criteria reduced the interval to 31 months (0-97) (p < 0.001). In 27 of these patients who did not satisfy both criteria at the same time, ADA criteria reduced the interval to 10 months (0-93) (p < 0.001).

Conclusions: Not performing the OGTT means a delay in diagnosis which can be countered by applying the ADA criteria.

Objetivo: Analizar el intervalo temporal entre la primera hiperglucemia basal ocasional (HBO) y el diagnóstico de diabetes mellitus tipo 2 (DM2) al aplicar los criterios de la OMS y de la Asociación Americana de Diabetes (ADA).

Diseño: Estudio observacional, retrospectivo. Ámbito del estudio. Centro de atención primaria urbano.

Sujetos: Un total de 104 pacientes con DM2, diagnosticados entre 1991 y 1995, con antecedentes de HBO.

Mediciones o intervenciones: Edad, género y otros factores de riesgo, fechas de la primera HBO (glucemia basal 3 110 mg/dl), del diagnóstico según criterios OMS (2 glucemias basales 3 140 mg/dl o 3 200 mg/dl a las 2 horas de la sobrecarga oral de glucosa [SOG]) y aplicando criterios ADA (2 glucemias basales 3 126 mg/dl) y los intervalos en meses entre ellas.

Resultados: De los 222 pacientes diagnosticados, 104 (47%) presentaban antecedentes de HBO. La edad en el momento del diagnóstico fue 60,8 años (DE, 10,1), siendo un 53% mujeres. En 51 casos (49%) se realizó SOG. La mediana (rango) del intervalo entre la primera HBO y el diagnóstico fue de 16 meses (0–101) en los que se realizó la SOG y de 45 (1–104) en los que no se practicó (p = 0,003). En estos últimos, los criterios ADA lo redujeron a 31 meses (0–97) (p < 0,001) y en 27 de ellos que no cumplían ambos criterios a la vez el intervalo fue de sólo 10 meses (0–93) (p < 0,001). Conclusiones. La no realización de la SOG comporta un retraso en el diagnóstico que puede ser contrarrestado con la aplicación de los criterios de la ADA.

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