Appropriate cut-offs. Young () Risk of bias American Indians Excluded pregnant women but Optimal Optimal FPG ROC Level III-2 Not reported Manitoba unclear due to recruited from the included people with pre-existing cut-offs cut-offs ≥7.8 analysis Cross-sectional and poor community, n=704, diabetes. reported reported study of some Ontario, reporting. aged 20–64 years. No randomly sampled Canada other details. and some Limited volunteers from six applicability American Indian as not a communities in relevant Canada. ethnic minority. Cut-offs only defined for FPG. Table 62: Study profiles of included studies on diagnostic accuracy of HbA1c testing for diagnosing diabetes in children Study Diagnostic level of Quality Study population Inclusion/exclusion criteria HbA1c HbA1c Reference Reference and evidence and assessment cut-off— cut-off— standard standard location study design diabetes (FPG cut-off(s): and/or OGT (FPG and/or OGT Lee () Some risk of Subgroup analysis of Included overweight and obese 6.0%≥ HbA1c 100 mg/dL≥ FPG ROC Level III-2 Multiple bias as larger adolescents. Excluded those who HbA1c ≥6.5% FPG ≥126 mg/dL; analysis Cross-sectional sites, USA results from cross-sectional were pregnant or known to be <6.5% <126 mg/dL; study of nationally OGT test as far back as study; n=1,156 diabetic. representative 5.7%≥ 140 mg/dL≥ ≥200 mg/dL 1999, which overweight and HbA1c 2hPG may not be obese adolescents population in USA, <6.5% <200 mg/dL equivalent to aged 12–18 years selected with more recent who had both FPG stratified random results. and HbA1c tests, sampling and with 52% male. Also adolescents No n=267 had OGT test. oversampled applicability (NHANES). Data concerns.
Appropriate cut-offs. Young () Manitoba and Ontario, Canada Level III-2 Cross-sectional study of some randomly sampled and some volunteers from six American Indian communities in Canada. Risk of bias unclear due to poor reporting. Limited applicability as not a relevant ethnic minority. Cut-offs only defined for FPG. American Indians recruited from the community, n=704, aged 20–64 years. No other details. Excluded pregnant women but included people with pre-existing diabetes. Optimal cut-offs reported Optimal cut-offs reported Not reported FPG ≥7.8 ROC analysis Table 62: Study profiles of included studies on diagnostic accuracy of HbA1c testing for diagnosing diabetes in children Study and location Diagnostic level of evidence and study design Quality assessment Study population Inclusion/exclusion criteria HbA1c cut-off— HbA1c cut-off— diabetes Reference standard (FPG and/or OGT Reference standard cut-off(s): (FPG and/or OGT Lee () Multiple sites, USA Level III-2 Cross-sectional study of nationally representative population in USA, selected with stratified random sampling and with adolescents oversampled (NHANES). Data Some risk of bias as results from as far back as 1999, which may not be equivalent to more recent results. No applicability concerns. Subgroup analysis of larger cross-sectional study; n=1,156 overweight and obese adolescents aged 12–18 years who had both FPG and HbA1c tests, 52% male. Also n=267 had OGT test. Included overweight and obese adolescents. Excluded those who were pregnant or known to be diabetic. 6.0%≥ HbA1c <6.5% 5.7%≥ HbA1c <6.5% HbA1c ≥6.5% 100 mg/dL≥ FPG <126 mg/dL; 140 mg/dL≥ 2hPG <200 mg/dL FPG ≥126 mg/dL; OGT test ≥200 mg/dL ROC analysis