Fasting plasma glucose diagnostic criterion, proposed by the American Diabetes Association, has low sensitivity for diagnoses of diabetes in Mexican population

To determine the best cutoff value of fasting plasma glucose (FPG) for diag nosis of diabetes, using the 2-h postglucose load (2-h PG) as the gold stan dard, in Mexican population and compare it to the 7.0 mmol/l limit proposed by the American Diabetes Association (ADA). 712 apparently healthy Mexican individuals were included in a cross-sectional randomized population surve y. Sensitivity of FPG criterion for diagnoses of type 2 diabetes was calcul ated from a fourfold table. Glycemia value 2-h PG of greater than or equal to 11.1 mmol/l was the "gold standard" diagnostic test. The optimal FPG val ue for diagnoses of diabetes was established on a receiver operating charac teristic (ROC) scatter plot. On the basis of the "gold standard" diagnostic test, diagnosis of type 2 diabetes was established in 65 (9.12%) subjects, whereas the ADA FPG diagnostic criterion only identified 39 (5.37%) subjec ts; that is a sensitivity of 6046 (CI95%, 47.1 - 72.0). The ROC scatter plo t showed the best cutoff value of FPG for diagnoses of diabetes that corres ponds to 6.1 mmol/l, which has the highest sensitivity (0.985). FPG diagnos tic criterion proposed by the ADA Expert Committee for diagnosis of type di abetes has low sensitivity in Mexican population. For epidemiological purpo ses. estimates of diabetes prevalence in Mexico based on a FPG value of gre ater than or equal to 6.1 mmol/l will improve the success of the screening. (C) 2001 Elsevier Science Inc. All rights reserved.