[Use of casual plasma glucose levels in community screening for diabetes mellitus].

The aim of this study was to assess the utility of casual plasma glucose as a screening test for diabetes mellitus in lieu of hemoglobin A1c (HbA1c) and urinary glucose. Casual plasma glucose and urinary glucose were measured in 1,024 individuals in a rural community. The individuals were then offered participation in an oral glucose tolerance test (OGTT). A 75 g OGTT based on WHO criteria was performed and HbA1c was measured in 290 respondents. Receiver operating characteristic (ROC) curves for casual plasma glucose and HbA1c were constructed and the areas under ROC curves for the tests were calculated. The area under the ROC curve for HbA1c was significantly higher than that for casual plasma glucose (p < 0.01). The sensitivity and specificity for casual plasma glucose > 140 mg/d/were 61% and 62%, respectively, while the specificity of HbA1c was 93% with a sensitivity of 61%. The sensitivity of urinary glucose was low (only 18%) with a comparable specificity (93%). It is concluded that measurement of casual plasma glucose is inferior to HbA1c as a screening test for diabetes.