Glycated hemoglobin A<sub>1c</sub> as a screening test for detecting type 2 diabetes mellitus in obese children and adolescents

Yoon, Jong Seo; So, Cheol Hwan; Lee, Hae Sang; Hwang, Jin Soon

doi:10.1515/jpem-2017-0463

Cited by 4 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The relevant literature contradicts the call for lowering HbA1 c cut-off values for youth, as suggested by several studies. Youths with a high HbA1 c above 6.2% must have an OGTT to establish the diagnosis of T2DM [27].…”

Section: What Are the Inadequacies Of The Current Diagnostic Criteriamentioning

confidence: 99%

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Brar

2019

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

The modalities currently employed to screen for type 2 diabetes mellitus (T2DM)/ prediabetes are HbA1c, fasting plasma glucose (FPG), and 2-hour plasma glucose (PG) during an oral glucose tolerance test (OGTT). The purpose of this review is to highlight the positive qualities and pitfalls of these diagnostic modalities and reflect on the most reasonable and effective approach to screen high risk youth. Given its inherent preanalytical advantages, glycated hemoglobin (HbA1c) continues to be the preferred diagnostic modality used by pediatricians to screen high risk youth. However, when the three aforementioned tests are performed in youths of different races/ethnicities, discrepant results for T2DM/prediabetes are observed. The prevalence rates for T2DM vary from 0.53% in Chinese youth (including youth of all body mass indexes) to 18.3% in high-risk, overweight, obese Korean youth. Moreover, the FPG is abnormal (>100 less than <126 mg/dL) in 15% of Korean youth versus 8.7% of Chinese youth. The prevalence rates for prediabetes are 1.49% in Chinese youth versus 21% in Emirati youth (HbA1c, 5.7%-6.4%). The coefficient of agreement, k, between these screening tests for T2DM are fair, 0.45-0.5 across all youth. However, using HbA1c as a comparator, the agreement is weak with FPG (k=0.18 in German youth versus k=0.396 in Korean youth). The American Diabetes Association (ADA) Standards of Medical Care Guidelines define "high risk youth" who need to be tested for T2DM and/or prediabetes. OGTT and HbA1c do not always detect T2DM in similar individuals. HbA1c may not be an ideal test for screening Hispanic and African American youth. FPG and OGTT are suitable screening tests for youth of ethnic minorities and those with cystic fibrosis or hemoglobinopathies. Performing all three tests either together or sequentially may be the only way to encompass all youth who have aberrations in different aspects of glucose homeostasis.

show abstract

Section: What Are the Inadequacies Of The Current Diagnostic Criteriamentioning

confidence: 99%

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Brar

2019

Ann Pediatr Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…Rochester, NY, USA) with VITROS reagents and control. Elevated HbA1c was defined ≥6.2%[25]. Plasma triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) concentrations and alanine aminotransferase (ALT) were determined with an immunoradiometric assay (Active Human Leptin IRMA, DSL-23100, Diagnostic System Laboratories Inc., Webster, TX, USA).…”

mentioning

confidence: 99%

Effect of Physical Activity and Nutrition Education on Body Mass Index, Blood Pressure and Biochemical Variables in Overweight and Obese Adolescents

Grace

Biggs

Naicker

et al. 2021

Annals of Global Health

View full text Add to dashboard Cite

Background: The majority of obese children lives in developing countries. The ten-fold increase in obesity during the last four decades necessitates the implementation of interventions to mitigate the longterm effect of obesity into adulthood. The study aimed to determine the impact of physical activity and nutrition intervention on the body mass index (BMI), blood pressure and selected biochemical factors of overweight and obese children aged 13.0 to 16.1 years from eThekweni, South Africa. Methods: Participants (N = 41) with a BMI >85 th percentile were included in the 10-week controlled trial of physical activity and nutrition education intervention. Baseline and end measurements included BMI, blood pressure, and fasting biochemical variables (glucose, cholesterol, insulin resistance and alanine aminotransferase). BMI was classified according to the WHO BMI z-scores. The 10-week intervention entailed combined aerobic and resistance exercises supervised twice a week together with a once a week nutrition intervention. Participants performed additional unsupervised aerobic exercises three times a week. Findings: Elevated systolic blood pressure (52%), low-density lipoprotein levels (29%), insulin (17%) and insulin resistance values (15%) were identified. The 10-week intervention programme significantly decreased BMI (30.8 ± 5.4 kg/m 2 to 29.8 ± 5.7 kg/m 2 ; p < 0.01), systolic blood pressure (125.9 ± 15.7 mmHg to 115.2 ± 12.4 mmHg; p < 0.05), and low-density lipoprotein cholesterol (2.63 mmol/L to 2.37 mmol/L; p < 0.05). Controlling for pre-testing variables as covariates, additional ANCOVA analysis highlighted significantly lower BMI (M = 28.33, F = 7.88, p < 0.05) and BMI z-scores (M = 2.08, F = 4.99, p < 0.05) in the intervention group post-testing. Conclusion: A 10-week physical activity and nutrition education intervention in overweight and obese adolescents significantly reduced BMI and showed trends of a decrease in blood pressure and low-density lipoprotein cholesterol.

show abstract

Obesity, putative biological mediators, and cognitive function in a national sample of children and adolescents

Smith

Toussaint

Micoli

et al. 2021

Preventive Medicine

View full text Add to dashboard Cite

Glycated hemoglobin A_1c as a screening test for detecting type 2 diabetes mellitus in obese children and adolescents

Abstract: We observed that the use of an HbA1c level of 6.5% had a lower sensitivity for detecting T2DM than an HbA1c level of >6.2%.

Cited by 4 publications

References 11 publications

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Effect of Physical Activity and Nutrition Education on Body Mass Index, Blood Pressure and Biochemical Variables in Overweight and Obese Adolescents

Obesity, putative biological mediators, and cognitive function in a national sample of children and adolescents

Contact Info

Product

Resources

About

Glycated hemoglobin A1c as a screening test for detecting type 2 diabetes mellitus in obese children and adolescents

Abstract: We observed that the use of an HbA1c level of 6.5% had a lower sensitivity for detecting T2DM than an HbA1c level of >6.2%.

Cited by 4 publications

References 11 publications

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Effect of Physical Activity and Nutrition Education on Body Mass Index, Blood Pressure and Biochemical Variables in Overweight and Obese Adolescents

Obesity, putative biological mediators, and cognitive function in a national sample of children and adolescents

Contact Info

Product

Resources

About

Glycated hemoglobin A_1c as a screening test for detecting type 2 diabetes mellitus in obese children and adolescents