| Objective:Plasma glucose is the main indicators in the diagnosis of diabetes up to now, but it is affected by stress factors. Thus, it can not be served as criteria for diabetic diagnosis under stress. Glycated hemoglobin can reflect the 2-3 months average plasma glucose, it is stable and seldom affected by stress factors. Hence, the aim of this study was to explore whether glycated hemoglobin can be served as criteria for diabetic diagnosis under stress and to discuss the cut point for diabetic diagnosis when using glycated hemoglobin as diagnostic criteria.Methods:Inpatients who were under stress and denied history of diabetes were collected during March 2008 to December 2009. The general information about these patients was recorded and their fasting plasma glucoses (FPG) were tested. The subject whose FPG was greater than 6.1mmol/l would be performed the measurement of glycated hemoglobin and tested FPG again after stress (2-3 months later). The people with impaired fasting glucose (IFG) were further carried out 75g oral glucose tolerance test and followed up every 3 months. The maximum period of follow-up was 16 months. During the period of follow-up, once the subject was diagnosed as diabetes according to the criteria of plasma glucose, then the follow-up was terminated.The subjects were divided into groups according to the levels of glycated hemoglobin under stress. The cut point of glycated hemoglobin for diabetic diagnosis was identified according to the prevalence of diabetes, subsequently its ability to diagnosis diabetes was compared with that by using FPG.Results:1.370 subjects were collected,225 cases were followed up regularly.After stress,125cases(55.6％)were diagnosed as diabetes,32 cases(14.2％)as impaired glucose regulation and 68 cases(30.2％)as normal plasma glucose according to the criteria of plasma glucose.2.The subjects were divided into two groups according to the level of glycated hemoglobin(HbAlc)respectively. After stress, diabetes was diagnosed with the criteria of plasma glucose.If the level of HbAlc used to separate the group was selected as 6.1％,6.2%,6.3％,6.4%,6.5％, 6.6％,6.7％,6.8％and 6.9％respectively,the prevalence of diabetes in corresponding groups were 75.48% (HbAlc≥6.1％) vs 11.43% (HbAlc<6.1％)(X2=80.13,p<0.05);79.86%(HbAlc≥6.2％)vs 16.28％(HbAlc<6.2％)(X2=86.97,p<0.05)；93.91%(HbAlc≥6.3%)vs 17.0% (HbAlc<6.3%)(X2=108.37,p<0.05)；89.38%(HbAlc≥6.4%)vs 21.43% (HbAlc<6.4%)(X2=105.19,p<0.05)；92.08％(HbAlc≥6.5%)vs 25.81% (HbAlc<6.5%)(X2=99.01,p<0.05)；95.24％(HbAlc≥6.6％)vs 31.91% (HbAlc<6.6%)(X2=85.49,p<0.05)；96.05％(HbAlc≥6.7％)vs 34.90％(HbAlc<6.7％)(X2=76.23,p<0.05)；98.53％(HbAlc≥6.8％)vs 36.94% (HbAlc<6.8％)(X2=72.89,p<0.05)and 100％(HbAlc≥6.9％)vs 64.0% (HbAlc<6.9％)(X2=68.47,p<0.05).The follow-up periods in corresponding groups were 3.89±3.01M vs 3.99±2.78M(p>0.05)；3.69±2.77M vs 4.29±3.17M(p>0.05);3.48±2.54M vs 4.47±3.23M(p<0.05);3.4±2.56M vs 4.41±3.20M(p<0.05)；3.31±2.55M vs 4.42±3.14M(p<0.05)；3.42±2.68M vs 4.22±3.04M(p<0.05);3.28±2.74M vs 4.25±2.98M(p<0.05);3.31±2.75M vs 4.18±2.98M(p<0.05)；3.16±2.74M vs 4.21±2.96M(p<0.05) respectively.3.If HbAlc 6.3％was selected as the cut point for diabetic diagnosis under stress,its sensitivity and specificity was 86.4％and 83％respectively for diagnosing diabetes.4.The prevalence of diabetes was 55.56%and 43.56%(X2=15.51, P<0.05)respectively when HbAlc 6.3％under stress and FPG after stress were selected as criteria for diagnising diabetes.5.HbAlc had not linear correlation with age,cholesterol and trigly-cerides.it also had not association with sex,family history of diabetes and disease under stress.Conclusion:1.HbAlc could be used as diagnostic indicators in the diagnosis of diabetes under stress, the diagnostic cut point of HbAlc was 6.3%, its sensitivity and specificity was 86.4% and 83% respectively for diagnosing diabetes.2. The capacity of diagnosing diabetes using HbAlc 6.3% was greater than that using fasting plasma glucose.3. HbAlc had not linear correlation with age, cholesterol and triglycerides,it also had not association with sex, family history of diabetes and disease under stress.
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