Change in guidelines for Type 2 diabetes screening may lead to under-diagnosis in children

February 11, 2014, University of Michigan Health System

New American Diabetes Association (ADA) screening guidelines may lead to the missed diagnoses of type 2 diabetes in children, according to a new study by University of Michigan.

The research, published in the Journal of Adolescent Health, finds that both pediatric and family medicine providers who care for are using screening tests for that may result in missed diagnoses for children, says lead author Joyce Lee, M.D., M.P.H., associate professor in U-M's Departments of Pediatrics and Communicable Diseases and Environmental Health Sciences.

In 2010, the ADA recommended that physicians use Hemoglobin A1c screening tests, rather than glucose tests for identifying children and adults with pre-diabetes and diabetes. However, this change has been controversial, because of lower test performance of HbA1c in children compared with adults.

The study found that when presented with the ADA screening guidelines, 84% of physicians reported that they would switch from using glucose tests to using HbA1c tests.

"This potential for increased uptake of HbA1c could lead to missed cases prediabetes and diabetes in children, and increased costs," says Lee.

"A number of studies have shown that HbA1c has lower test performance in pediatric compared with adult populations, and as a result, increased uptake of HbA1c alone or in combination with non-fasting tests could lead to missed diagnoses of type 2 diabetes in the pediatric population.

'"Also, a recent analysis of screening strategies found that HbA1c is much less cost-effective than other screening tests, which would result in higher overall costs for screening."

The study was based on a national sample of providers from pediatrics and family practice.

"Greater awareness of the 2010 ADA guidelines will likely lead to increased uptake of HbA1c and a shift to use of non-fasting tests to screen for adolescents with type 2 diabetes. This may have implications for detection rates for diabetes and overall costs of screening."

Explore further: American Diabetes Association's preferred testing method fails to identify kids with diabetes

Related Stories

American Diabetes Association's preferred testing method fails to identify kids with diabetes

November 21, 2011
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 ...

Fasting plasma glucose beats HbA1c for diabetes screening

January 17, 2013
(HealthDay)—For patients without diabetes undergoing coronary angiography (CAG), fasting plasma glucose (FPG) performs better in diabetes screening than glycated hemoglobin (HbA1c), according to a study published online ...

Study indicates the potential of new tests in long-term diabetes complications

January 14, 2014
Monitoring glucose levels is imperative for diabetes patients, but for some the standard Hemoglobin A1c (HbA1c) test is not valid. Researchers from Johns Hopkins University, the University of Wisconsin, and the University ...

Most youth with type 1 diabetes don't meet HbA1c goals

February 8, 2013
(HealthDay)—Most children with type 1 diabetes (T1D) have hemoglobin A1c (HbA1c) values above target levels, according to a study published online Jan. 22 in Diabetes Care.

2 tests better than 1 to diagnose diabetes in overweight children

May 2, 2011
A new study found that the recommended blood test may not be enough to catch type 2 diabetes in overweight children, missing more than two-thirds of children at high-risk for the condition. Researchers from Children's Mercy ...

Recommended for you

Genetic discovery may help better identify children at risk for type 1 diabetes

January 17, 2018
Six novel chromosomal regions identified by scientists leading a large, prospective study of children at risk for type 1 diabetes will enable the discovery of more genes that cause the disease and more targets for treating ...

Thirty-year study shows women who breastfeed for six months or more reduce their diabetes risk

January 16, 2018
In a long-term national study, breastfeeding for six months or longer cuts the risk of developing type 2 diabetes nearly in half for women throughout their childbearing years, according to new Kaiser Permanente research published ...

Women who have gestational diabetes in pregnancy are at higher risk of future health issues

January 16, 2018
Women who have gestational diabetes mellitus (GDM) during pregnancy have a higher than usual risk of developing type 2 diabetes, hypertension, and ischemic heart disease in the future, according to new research led by the ...

Diabetes gene found that causes low and high blood sugar levels in the same family

January 15, 2018
A study of families with rare blood sugar conditions has revealed a new gene thought to be critical in the regulation of insulin, the key hormone in diabetes.

Discovery could lead to new therapies for diabetics

January 12, 2018
New research by MDI Biological Laboratory scientist Sandra Rieger, Ph.D., and her team has demonstrated that an enzyme she had previously identified as playing a role in peripheral neuropathy induced by cancer chemotherapy ...

Enzyme shown to regulate inflammation and metabolism in fat tissue

January 11, 2018
The human body has two primary kinds of fat—white fat, which stores excess calories and is associated with obesity, and brown fat, which burns calories in order to produce heat and has garnered interest as a potential means ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.