American Diabetes Association's preferred testing method fails to identify kids with diabetes
In 2009, the American Diabetes Association (ADA) recommended that Hemoglobin A1c be exclusively used for the diagnosis of diabetes in children. The simple test measures longer-term blood sugar levels -- without requiring patients to fast overnight. However, a new U-M study has shown that these tests are not very accurate in children.
"We found that Hemoglobin A1c is not as reliable a test for identifying children with diabetes or children at high risk for diabetes compared with other tests in children," says Joyce M. Lee, M.D., M.P.H., lead author of the study and a pediatric endocrinologist at U-M's C.S. Mott Children's Hospital. "In fact, it failed to diagnose two out of three children participating in the study who truly did have diabetes."
Although tests that require patients to fast are the most accurate tests, they are difficult to obtain in clinical practice, highlighting the need for improved nonfasting testing strategies.
Due in part to high rates of childhood obesity, the Centers for Disease Control estimates that approximately 2.5 million children in the U.S. currently qualify for diabetes screening.
The study, published online ahead of print in the journal Diabetes Care, tested 254 overweight children using both fasting and non-fasting methods. Researchers found that the recommended test, Hemoglobin A1c, missed more cases of pre-diabetes or diabetes compared to other tests.
Participants in the study were defined as having prediabetes or diabetes based on a gold standard test. They were first tested using the Hemoglobin A1C test. After fasting for 12 hours, they returned on a separate day and were tested using a fasting method.
Based on the results, researchers urge that a nonfasting one-hour glucose challenge test, or a random glucose, may be promising methods for identifying children with prediabetes or diabetes.
"Other pediatric organizations, like the American Academy of Pediatrics, have not endorsed the use of HbA1c yet. However, there is concern that should they endorse it, more and more providers would use these testing methods, leading to an increase in missed diagnoses in the pediatric population," says Lee.
Researchers intend to use their data to drive future recommendations about screening for diabetes.
"We are currently studying whether the promising nonfasting tests, including the 1-hour glucose challenge test or the random glucose, could be used in combination with clinical characteristics to better identify which children have prediabetes or diabetes," says Lee.
Provided by University of Michigan Health System
- Convenient blood test not as effective for diagnosing diabetes in children Feb 23, 2011 | not rated yet | 0
- 2 tests better than 1 to diagnose diabetes in overweight children May 02, 2011 | not rated yet | 0
- New insights in diagnosing diabetes may help the millions who are undiagnosed May 27, 2008 | not rated yet | 0
- Glucose challenge test is accurate and economical for diabetes and prediabetes screening Jun 25, 2009 | not rated yet | 0
- Hemoglobin A1c outperforms fasting glucose for risk prediction Mar 03, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
A paper recently published in the New England Journal of Medicine and co-written by physicians and scientists at the University of Colorado School of Medicine finds that an important genetic risk factor for pulmonary fibros ...
Diseases, Conditions, Syndromes 8 hours ago | not rated yet | 0
Using the Department of Defense Serum Repository (DoDSR), University of Cincinnati (UC) researchers have identified a number of biomarkers for inflammatory bowel disease (IBD), which could help with earlier diagnosis and ...
Diseases, Conditions, Syndromes 8 hours ago | 5 / 5 (1) | 0
(HealthDay)—Three-quarters of public schools in the metro Atlanta area contain microbes, including bacteria indicating the presence of fecal matter, according to research published in the May 17 issue of ...
Diseases, Conditions, Syndromes 9 hours ago | not rated yet | 0
(HealthDay)—Factors such as increased case finding may explain why Michigan had half of the total spinal infections associated with contaminated methylprednisolone acetate in the recent fungal meningitis ...
Diseases, Conditions, Syndromes 9 hours ago | not rated yet | 0
The world is unprepared for a massive virus outbreak, the deputy chief of the World Health Organization warned Tuesday, amid fears that H7N9 bird flu striking China could morph into a form that spreads easily among people.
Diseases, Conditions, Syndromes 10 hours ago | not rated yet | 0
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
14 hours ago | 4.2 / 5 (5) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
12 hours ago | 4.9 / 5 (11) | 0 |
An experimental sleeping pill from US drug company Merck is effective at helping people fall and stay asleep, according to reviewers at the US Food and Drug Administration, which could soon approve the new drug.
8 hours ago | 3 / 5 (2) | 0
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
14 hours ago | 4.6 / 5 (7) | 0 |
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...
9 hours ago | 5 / 5 (4) | 0 |
A drug commonly used to treat depression and anxiety may improve a stress-related heart condition in people with stable coronary heart disease, according to researchers at Duke Medicine.
10 hours ago | 5 / 5 (1) | 0 |