Not Yet Suitable for Children

Simple blood test not as reliable for diagnosing diabetes in children

(RxWiki News) A simple blood glucose test commonly used to diagnose diabetes and pre-diabetes may not be the best method for diagnosing diabetes in children, according to a new study from the University of Michigan.

The hemoglobin A1c test is used to measure longer-term blood sugar levels without requiring patients to abstain from eating the night before testing. It has become the preferred method to diagnose diabetes among those who have diabetes but show no symptoms.

However, researchers at the University of Michigan's C.S. Mott Children's Hospital say that more research needs to be conducted before doctors can rely on the test to diagnose diabetes in children. According to lead author Joyce M. Lee, M.D., M.P.H., a pediatric endocrinologist at Mott Children's Hospital, the hemoglobin A1c test is not reliable for identifying children with diabetes and pre-diabetes. Consequently, it could mean that some diabetic children go undiagnosed.

Current guidelines from the American Diabetes Association (ADA) recommend that hemoglobin A1c should be used to diagnose diabetes in children and adults. According to the ADA recommendations, a hemoglobin A1c value of 6.5 percent or more means that a patient has diabetes, and a value of 6 to 6.4 percent signifies pre-diabetes.

After a study of 1,156 obese and overweight adolescents between the ages of 12 and 18, Dr. Lee and colleagues disagree with the rapid discarding of other diagnosis tests such as the fasting plasma glucose and 2-hour plasma glucose measurements. Past research and years of use have shown that the plasma glucose tests are important for the diagnosis of diabetes in children.

According to the study's authors, it's too early to tell if the hemoglobin A!c test is effective in diagnosing diabetes in children. More research is needed before doctors can safely rely on the test. Until then, says Dr. Lee, a fasting blood glucose test should still be used for diagnosing diabetes in children.

While about 18.8 million people in the United States have been diagnosed with diabetes, another 7 million are undiagnosed, in addition to the 79 million people with pre-diabetes. With approximately 1.9 million new cases of diabetes each year, it is important to have effective tools to diagnose the disease early so that patients can change their lifestyles to treat the disease.

The University of Michigan study - which was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Child Health & Human Development, among others - appears online ahead of prong in the Journal of Pediatrics.

Review Date: 
February 23, 2011