Diabetes screening test missing the mark?

February 25, 2014

The current recommended screening test for type 2 diabetes mellitus may be missing the diagnosis in many adolescents, according to a new study by the University of Michigan in Ann Arbor.

 

The current recommended screening test for type 2 diabetes mellitus may be missing the diagnosis in many adolescents, according to a new study by the University of Michigan in Ann Arbor.

In 2010, the American Diabetes Association (ADA) recommended that physicians use the easier hemoglobin A1c (HbA1c) tests, rather than fasting plasma glucose tests that require 8 hours of fasting, to screen for diabetes and prediabetes in children and adults.

According to the study, which surveyed 1,400 US pediatricians and family practitioners, barely more than a third (38%) of those physicians surveyed are aware of the ADA testing recommendations. In addition, barely more than half (58%) are using HbA1c tests (35% order HbA1c tests in conjunction with fasting tests and 22% order them alone or with nonfasting tests). However, two-thirds (67%) of those surveyed said they would change their screening practices, and 84% reported that they would now order HbA1c tests as a result of finding out about the ADA recommendations.

This latest study says this practice may not be such a good thing. The University of Michigan Comprehensive Diabetes Center explains that research has shown that HbA1c tests are not as effective in children as they are in adults, which means that increased uptake of HbA1c alone or in combination with nonfasting tests could lead to an increased number of missed diagnoses of diabetes and prediabetes in children.

The researchers also claim that HbA1c tests are not as cost-effective as glucose tests, which would raise the overall cost of screening. 

 

 

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