Version August 2025
| Sensitivity %, (95% CI) | Specificity %, (95% CI) | Reference standard | |
| Diabetes | |||
| Glycated hemoglobin (A1C)* ≥6.5% (≥48 mmol/mol) | 68.4 (46.6 to 84.3) | 95.9 (85.4 to 98.9) | OGTT¶ |
| Fasting plasma glucose (FPG)* ≥126 mg/dL (≥7 mmol/L) | 56.0 (36.6 to 73.8) | 97.9 (91.6 to 99.5) | OGTT¶ |
| Combined testing (A1C and FPG)Δ | 54.9 (48.8 to 60.9) | 98.1 (97.8 to 98.3) | Clinical diabetes at 5-year follow-up◊ |
| Combined testing (A1C and FPG)Δ | 22.9 (20.7 to 25.2) | 99.4 (99.3 to 99.6) | Clinical diabetes at 10-year follow-up◊ |
| Prediabetes | |||
| Glycated hemoglobin (A1C)§ 5.7 to 6.4% (38.3 to 46.4 mmol/mol) | 49 (40 to 58) | 79 (73 to 84) | OGTT¥ |
| Fasting plasma glucose (FPG)§ 100 to 125 mg/dL (5.6 to 6.9 mmol/L) | 25 (19 to 32) | 94 (92 to 96) | OGTT¥ |
ADA: American Diabetes Association; OGTT: oral glucose tolerance test; WHO: World Health Organization.
* Sensitivities and specificities are pooled estimates derived from meta-analysis of 9 studies.[1]
¶ Abnormal OGTT defined as 2-hour plasma glucose ≥200 mg/dL (≥11.1 mmol/L).[1]
Δ Data from prospective cohort analysis of Atherosclerosis Risk in Communities (ARIC) study. Combined testing defined diabetes as abnormal results on A1C testing (≥6.5% [≥48 mmol/mol] and FPG ≥126 mg/dL [≥7 mmol/L]).[2]
◊ Clinical diabetes defined as self-reported use of glucose-lowering medication or clinician diagnosis of diabetes.[2]
§ Sensitivities and specificities are pooled estimates derived from meta-analysis of studies using both WHO and ADA diagnostic criteria for "at-risk" A1C and impaired fasting glucose.[3]
¥ Reference standard is an abnormal 2-hour OGTT.[3]
