Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
To the Editor: The article by Dr Davidson and
colleagues1 strives to bring balance to
the effects of the changes in diagnostic criteria for type 2 diabetes mellitus.
Studies such as this can lead to further refinement in the characterization
of patients along the spectrum of impaired glucose metabolism.
However, I noted a logical error in the article. The authors stated
that a patient with a fasting plasma glucose (FPG) concentration of less than
7.0 mmol/L (126 mg/dL) but with a 2-hour value of 11.1 mmol/L (200 mg/dL)
or more during oral glucose tolerance testing (OGTT) would be diagnosed as
having diabetes by the old criteria but as having impaired FPG by the new
criteria. This is incorrect according to the wording of the new criteria provided
in the article. Since either an FPG concentration of 7.0 mmol/L (126 mg/dL)
or higher or 2-hour FPG concentration of 11.1 mmol/L
(200 mg/dL) or more during OGTT qualifies for a diagnosis of diabetes, this
patient would be diagnosed as having diabetes by the new criteria, provided
both test results were known by the diagnostician.
Rayburn K. Glycosylated Hemoglobin as a Diagnostic Test for Type 2 Diabetes Mellitus. JAMA. 2000;283(5):605-607. doi:10.1001/jama.283.5.601