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. 2017 Sep 20;7:11968. doi: 10.1038/s41598-017-12210-z

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Screening strategies for detecting diabetes by an OGTT after use of (a) the FPG criteria, (b) the combination of FPG and HbA_1c, or (c) the combination of FPG and 1,5-AG. The proportions of the study population in specific diagnostic categories were: (a) FPG < 5.6 mmol/L to exclude and FPG ≥ 7.0 mmol/L to diagnose diabetes, with 43.1% participants needing an OGTT to confirm the diagnose. The sensitivity, specificity, PPV, and NPV for this strategy were 47.3%, 100%, 100%, and 67.7%, respectively. (b) As for the combined criteria of FPG and HbA_1c criteria, FPG < 5.6 mmol/L and HbA_1c < 5.7% to exclude diabetes, and FPG ≥ 7.0 mmol/L and/or HbA_1c ≥ 6.5% to confirm diabetes, 46.8% participants needed an OGTT. The sensitivity, specificity, PPV, and NPV for this strategy were 70.2%, 100%, 100%, and 78.8%, respectively. (c) With the combined FPG and 1,5-AG criteria, which are FPG < 5.6 mmol/L and 1,5-AG > 15.9 μg/mL for exclusion of diabetes, and FPG ≥ 7.0 mmol/L and/or 1,5-AG ≤ 15.9 μg/mL for the diagnosis of diabetes, only 24.2% participants needed an OGTT. The sensitivity, specificity, PPV, and NPV for this strategy were 78.7%, 72.3%, 72.0%, and 78.9%, respectively. Abbreviations: DM: diabetes mellitus; FPG: fasting plasma glucose; HbA _1c : glycated hemoglobin A_1c; NPV: negative predictive value; OGTT: oral glucose tolerance test; PPV: positive predictive value.