Use of hemoglobin A1C to detect Haitian-Americans with undiagnosed Type 2 diabetes

Arq Bras Endocrinol Metabol. 2012 Oct;56(7):449-55. doi: 10.1590/s0004-27302012000700007.


Objective: To evaluate the validity of hemoglobin A1C (A1C) as a diagnostic tool for type 2 diabetes and to determine the most appropriate A1C cutoff point for diagnosis in a sample of Haitian-Americans.

Subjects and methods: Subjects (n = 128) were recruited from Miami-Dade and Broward counties, FL. Receiver operating characteristics (ROC) analysis was run in order to measure sensitivity and specificity of A1C for detecting diabetes at different cutoff points.

Results: The area under the ROC curve was 0.86 using fasting plasma glucose ≥ 7.0 mmol/L as the gold standard. An A1C cutoff point of 6.26% had sensitivity of 80% and specificity of 74%, whereas an A1C cutoff point of 6.50% (recommended by the American Diabetes Association - ADA) had sensitivity of 73% and specificity of 89%.

Conclusions: A1C is a reliable alternative to fasting plasma glucose in detecting diabetes in this sample of Haitian-Americans. A cutoff point of 6.26% was the optimum value to detect type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Glucose / analysis*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / ethnology
  • Fasting / blood
  • Female
  • Glucose Tolerance Test
  • Glycated Hemoglobin A / analysis*
  • Haiti / ethnology
  • Humans
  • Male
  • ROC Curve
  • Sensitivity and Specificity
  • United States


  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human