Using hemoglobin A1c for prediabetes and diabetes diagnosis in adolescents

Can adult recommendations be upheld for pediatric use?

Laura Kester, Hilde Hey, Tamara S. Hannon

Research output: Contribution to journalReview article

19 Citations (Scopus)

Abstract

The obesity epidemic has resulted in more young people having high-risk profiles for the development of type 2 diabetes. Screening to promote earlier diagnosis and treatment of type 2 diabetes is of significant importance, as untreated disease leads to metabolic, microvascular, and macrovascular complications. However, the choice of screening methodology in adolescents is controversial, and implementation of screening protocols is not uniform. Expert panels have recommended the use of glycated hemoglobin (A1c) for the diagnosis of prediabetes and diabetes, based on the facts that the A1c assay has technical advantages and correlates well with the risk of microvascular diabetes. However, these recommendations are based strictly on data from adult studies and lack any input based on pediatric research. The pediatric research that has been published on the topic indicates that using adult cutoff points for A1c values to predict prediabetes or diabetes significantly underestimates the prevalence of these conditions in the pediatric and adolescent population. Therefore, we call for further investigation of the role of A1c for the diagnosis of prediabetes and diabetes in adolescents before its adoption as a principal diagnostic method in pediatric populations. We contend that a more comprehensive diabetes evaluation, along with A1c, remains necessary for screening adolescents at high risk for prediabetes and type 2 diabetes. Collaborative multicentered studies of prediabetes and type 2 diabetes in the obese pediatric population are especially needed to determine the A1c cutoff points, as well as other diagnostic measures, that best predict diabetes-related comorbid conditions later in life.

Original languageEnglish (US)
Pages (from-to)321-323
Number of pages3
JournalJournal of Adolescent Health
Volume50
Issue number4
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

Fingerprint

Prediabetic State
Hemoglobins
Type 2 Diabetes Mellitus
Pediatrics
Population
Glycosylated Hemoglobin A
Research
Early Diagnosis
Obesity

Keywords

  • Hemoglobin A1c
  • Type 2 diabetes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Using hemoglobin A1c for prediabetes and diabetes diagnosis in adolescents : Can adult recommendations be upheld for pediatric use? / Kester, Laura; Hey, Hilde; Hannon, Tamara S.

In: Journal of Adolescent Health, Vol. 50, No. 4, 01.04.2012, p. 321-323.

Research output: Contribution to journalReview article

@article{8126a0bb02e34a9081c7bbb760266746,
title = "Using hemoglobin A1c for prediabetes and diabetes diagnosis in adolescents: Can adult recommendations be upheld for pediatric use?",
abstract = "The obesity epidemic has resulted in more young people having high-risk profiles for the development of type 2 diabetes. Screening to promote earlier diagnosis and treatment of type 2 diabetes is of significant importance, as untreated disease leads to metabolic, microvascular, and macrovascular complications. However, the choice of screening methodology in adolescents is controversial, and implementation of screening protocols is not uniform. Expert panels have recommended the use of glycated hemoglobin (A1c) for the diagnosis of prediabetes and diabetes, based on the facts that the A1c assay has technical advantages and correlates well with the risk of microvascular diabetes. However, these recommendations are based strictly on data from adult studies and lack any input based on pediatric research. The pediatric research that has been published on the topic indicates that using adult cutoff points for A1c values to predict prediabetes or diabetes significantly underestimates the prevalence of these conditions in the pediatric and adolescent population. Therefore, we call for further investigation of the role of A1c for the diagnosis of prediabetes and diabetes in adolescents before its adoption as a principal diagnostic method in pediatric populations. We contend that a more comprehensive diabetes evaluation, along with A1c, remains necessary for screening adolescents at high risk for prediabetes and type 2 diabetes. Collaborative multicentered studies of prediabetes and type 2 diabetes in the obese pediatric population are especially needed to determine the A1c cutoff points, as well as other diagnostic measures, that best predict diabetes-related comorbid conditions later in life.",
keywords = "Hemoglobin A1c, Type 2 diabetes",
author = "Laura Kester and Hilde Hey and Hannon, {Tamara S.}",
year = "2012",
month = "4",
day = "1",
doi = "10.1016/j.jadohealth.2012.02.009",
language = "English (US)",
volume = "50",
pages = "321--323",
journal = "Journal of Adolescent Health",
issn = "1054-139X",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Using hemoglobin A1c for prediabetes and diabetes diagnosis in adolescents

T2 - Can adult recommendations be upheld for pediatric use?

AU - Kester, Laura

AU - Hey, Hilde

AU - Hannon, Tamara S.

PY - 2012/4/1

Y1 - 2012/4/1

N2 - The obesity epidemic has resulted in more young people having high-risk profiles for the development of type 2 diabetes. Screening to promote earlier diagnosis and treatment of type 2 diabetes is of significant importance, as untreated disease leads to metabolic, microvascular, and macrovascular complications. However, the choice of screening methodology in adolescents is controversial, and implementation of screening protocols is not uniform. Expert panels have recommended the use of glycated hemoglobin (A1c) for the diagnosis of prediabetes and diabetes, based on the facts that the A1c assay has technical advantages and correlates well with the risk of microvascular diabetes. However, these recommendations are based strictly on data from adult studies and lack any input based on pediatric research. The pediatric research that has been published on the topic indicates that using adult cutoff points for A1c values to predict prediabetes or diabetes significantly underestimates the prevalence of these conditions in the pediatric and adolescent population. Therefore, we call for further investigation of the role of A1c for the diagnosis of prediabetes and diabetes in adolescents before its adoption as a principal diagnostic method in pediatric populations. We contend that a more comprehensive diabetes evaluation, along with A1c, remains necessary for screening adolescents at high risk for prediabetes and type 2 diabetes. Collaborative multicentered studies of prediabetes and type 2 diabetes in the obese pediatric population are especially needed to determine the A1c cutoff points, as well as other diagnostic measures, that best predict diabetes-related comorbid conditions later in life.

AB - The obesity epidemic has resulted in more young people having high-risk profiles for the development of type 2 diabetes. Screening to promote earlier diagnosis and treatment of type 2 diabetes is of significant importance, as untreated disease leads to metabolic, microvascular, and macrovascular complications. However, the choice of screening methodology in adolescents is controversial, and implementation of screening protocols is not uniform. Expert panels have recommended the use of glycated hemoglobin (A1c) for the diagnosis of prediabetes and diabetes, based on the facts that the A1c assay has technical advantages and correlates well with the risk of microvascular diabetes. However, these recommendations are based strictly on data from adult studies and lack any input based on pediatric research. The pediatric research that has been published on the topic indicates that using adult cutoff points for A1c values to predict prediabetes or diabetes significantly underestimates the prevalence of these conditions in the pediatric and adolescent population. Therefore, we call for further investigation of the role of A1c for the diagnosis of prediabetes and diabetes in adolescents before its adoption as a principal diagnostic method in pediatric populations. We contend that a more comprehensive diabetes evaluation, along with A1c, remains necessary for screening adolescents at high risk for prediabetes and type 2 diabetes. Collaborative multicentered studies of prediabetes and type 2 diabetes in the obese pediatric population are especially needed to determine the A1c cutoff points, as well as other diagnostic measures, that best predict diabetes-related comorbid conditions later in life.

KW - Hemoglobin A1c

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=84858786743&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84858786743&partnerID=8YFLogxK

U2 - 10.1016/j.jadohealth.2012.02.009

DO - 10.1016/j.jadohealth.2012.02.009

M3 - Review article

VL - 50

SP - 321

EP - 323

JO - Journal of Adolescent Health

JF - Journal of Adolescent Health

SN - 1054-139X

IS - 4

ER -