Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio
Elevated Fulminant Index (FI), [plasma glucose (PG)/glycosylated hemoglobin A1c (HbA1c)], was reportedly a sensitive index to differentiate fulminant type 1 diabetes (FT1D) from non-fulminant T1D (nFT1D). Aim of this study was to describe a better, but simpler index of FT1D. 49 and 52 patients with...
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| Format: | Article |
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The Japan Endocrine Society
2024-11-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/71/11/71_EJ24-0226/_html/-char/en |
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| author | Jun-Ichiro Mori Takahiro Miyakoshi Hanae Yuzuriha Teruki Kondo Eita Nishimori Motoji Naka Ai Sato Mitsuhisa Komatsu Koh Yamashita Toru Aizawa |
| author_facet | Jun-Ichiro Mori Takahiro Miyakoshi Hanae Yuzuriha Teruki Kondo Eita Nishimori Motoji Naka Ai Sato Mitsuhisa Komatsu Koh Yamashita Toru Aizawa |
| author_sort | Jun-Ichiro Mori |
| collection | DOAJ |
| description | Elevated Fulminant Index (FI), [plasma glucose (PG)/glycosylated hemoglobin A1c (HbA1c)], was reportedly a sensitive index to differentiate fulminant type 1 diabetes (FT1D) from non-fulminant T1D (nFT1D). Aim of this study was to describe a better, but simpler index of FT1D. 49 and 52 patients with FT1D and nFT1D, respectively, were registered, and the discriminating ability of the rounded, normalized ratio, [PG (mmol/L) – 5.0]/[HbA1c (%) – 5.0], and the original ratio, [PG (mmol/L)]/[HbA1c (%)], was compared. Normalizing the ratio significantly raised its accuracy: area under the curve for receiver operating curve, AUROC (95%CI), 0.927 (0.858–0.964) and 0.851 (0.763–0.910), respectively, with and without the normalization (p < 0.01). Rounding of the figure into [PG (mmol/L) – 5.0]/[HbA1c (%) – 5.0] did not significantly sacrifice the discriminating ability of the index. Namely, the optimal cut point of rounded and normalized GAR, 10.0, showed 89.8% sensitivity. In conclusion, rounded, normalized (rn) GAR ≥10 (the rounded optimal cut-off) could be used for the snap diagnosis of FT1D. |
| format | Article |
| id | doaj-art-392bbc6dd28e4a919ef51e42ce8abe51 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-392bbc6dd28e4a919ef51e42ce8abe512025-01-22T05:38:19ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-11-0171111093109610.1507/endocrj.EJ24-0226endocrjSnap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratioJun-Ichiro Mori0Takahiro Miyakoshi1Hanae Yuzuriha2Teruki Kondo3Eita Nishimori4Motoji Naka5Ai Sato6Mitsuhisa Komatsu7Koh Yamashita8Toru Aizawa9Department of Medical Education, Shinshu University, Matsumoto 390-8621, JapanDiabetes Center, Aizawa Hospital, Matsumoto 390-8510, JapanResident of Internal Medicine, Aizawa Hospital, Matsumoto 390-8510, JapanDiabetes, Endocrinology and Metabolism, Nagano Chuo Hospital, Nagano 380-0814, JapanDepartment of Diabetes Medicine, Asama Central Hospital, Nagano 385-8558, JapanDepartment of Diabetes Medicine, Asama Central Hospital, Nagano 385-8558, JapanDiabetes Center, Okaya City Hospital, Okaya 394-0028, JapanDepartment of Diabetes, Endocrinology and Metabolism, Division of Internal Medicine, Shinshu University Hospital, Matsumoto 390-8621, JapanDiabetes Center, Aizawa Hospital, Matsumoto 390-8510, JapanDiabetes Center, Aizawa Hospital, Matsumoto 390-8510, JapanElevated Fulminant Index (FI), [plasma glucose (PG)/glycosylated hemoglobin A1c (HbA1c)], was reportedly a sensitive index to differentiate fulminant type 1 diabetes (FT1D) from non-fulminant T1D (nFT1D). Aim of this study was to describe a better, but simpler index of FT1D. 49 and 52 patients with FT1D and nFT1D, respectively, were registered, and the discriminating ability of the rounded, normalized ratio, [PG (mmol/L) – 5.0]/[HbA1c (%) – 5.0], and the original ratio, [PG (mmol/L)]/[HbA1c (%)], was compared. Normalizing the ratio significantly raised its accuracy: area under the curve for receiver operating curve, AUROC (95%CI), 0.927 (0.858–0.964) and 0.851 (0.763–0.910), respectively, with and without the normalization (p < 0.01). Rounding of the figure into [PG (mmol/L) – 5.0]/[HbA1c (%) – 5.0] did not significantly sacrifice the discriminating ability of the index. Namely, the optimal cut point of rounded and normalized GAR, 10.0, showed 89.8% sensitivity. In conclusion, rounded, normalized (rn) GAR ≥10 (the rounded optimal cut-off) could be used for the snap diagnosis of FT1D.https://www.jstage.jst.go.jp/article/endocrj/71/11/71_EJ24-0226/_html/-char/enfulminant type 1 diabetesketoacidosisdiagnosis |
| spellingShingle | Jun-Ichiro Mori Takahiro Miyakoshi Hanae Yuzuriha Teruki Kondo Eita Nishimori Motoji Naka Ai Sato Mitsuhisa Komatsu Koh Yamashita Toru Aizawa Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio Endocrine Journal fulminant type 1 diabetes ketoacidosis diagnosis |
| title | Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio |
| title_full | Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio |
| title_fullStr | Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio |
| title_full_unstemmed | Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio |
| title_short | Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio |
| title_sort | snap diagnosis of fulminant type 1 diabetes by the normalized glucose hba1c ratio |
| topic | fulminant type 1 diabetes ketoacidosis diagnosis |
| url | https://www.jstage.jst.go.jp/article/endocrj/71/11/71_EJ24-0226/_html/-char/en |
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