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Furthermore, the combination the two tests together is not an unconventional practise and
has been in international literature and observed in local practice. For example, in a study by
Lim and colleagues (2018) that assessed test performance of HbA1c and FPG among
Chinese, Malay and Indian residents in Singapore recommended the combination of HbA1c
and FPG would improve identification of individuals with DM and pre-diabetes. A separate
study by Heianza and colleagues (2011) that systematically assessed the incidence of
diabetes in a longitudinal cohort study in Japan observed that combining the two tests could
detect more individuals in need of timely intervention.

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