Vol. 9, Issue 2, Part A (2025)

Dysglycemia, which includes impaired glucose tolerance, impaired fasting glucose, and diabetes mellitus, is an increasing global health issue, especially in developing countries like Bangladesh. Early and precise diagnosis is crucial for preventing complications and ensuring timely intervention. Diagnostic methods such as fasting blood glucose, oral glucose tolerance tests, and HbA1c levels are widely used, offering specific benefits and drawbacks. This study aimed to evaluate the diagnostic procedures for dysglycemia.

Methods: This cross-sectional study was conducted at the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2019 to February 2020. A total of 1,165 individuals attending the Endocrinology Outpatient Department at BSMMU for dysglycemia (prediabetes and diabetes) screening were enrolled using non-probability sampling. Data analysis was performed using SPSS version 23.0.

Results: This study assessed diabetes and prediabetes using ADA criteria. Prevalence of diabetes was 21.2% (2hPG), 15.9% (FPG), and 23.3% (HbA1C), with prediabetes rates of 28.4% (FPG), 24.5% (2hPG), and 37.8% (HbA1C). No significant difference between 2hPG and HbA1C was found, but FPG underestimated diabetes. Concordance among tools was 12.4%, and the highest detection rate (25.6%) occurred with 2hPG and HbA1C. Age-influenced diagnosis and good agreement were found among FPG, 2hPG, and HbA1C. FPG showed lower sensitivity but similar specificity to HbA1C.

Conclusion: This study highlights the variability in dysglycemia diagnostics, with HbA1C and 2hPG showing higher detection rates than FPG, which underestimates diabetes. Age influences diagnosis, and good agreement among FPG, 2hPG, and HbA1C emphasizes the need for careful diagnostic consideration.