Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter April 13, 2018

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

  • Jong Seo Yoon , Cheol Hwan So , Hae Sang Lee and Jin Soon Hwang EMAIL logo

Abstract

Background:

The diagnostic cutoff points for indicators of type 2 diabetes mellitus (T2DM) in the pediatric population have not been defined thus far.

Methods:

A retrospective, single-center study was conducted from April 2003 to May 2016. We enrolled 236 overweight or obese children and adolescents aged 4–17 years. Thirty-nine (26.9%) of 145 patients had T2DM according to the oral glucose tolerance test results.

Results:

A glycated hemoglobin (HbA1c) level of 6.5% had a sensitivity and specificity of 87.2% and 98.5%, respectively, for detecting T2DM. The optimal HbA1c cutoff level for T2DM was >6.2% (94.7% sensitivity, 95.5% specificity).

Conclusions:

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%.

  1. Author contributions: J.S. Yoon conceptualized and designed the study, enrolled the subjects, carried out the initial analysis and drafted the initial manuscript; C.H. So conceptualized and designed the study, carried out the initial statistical analysis and reviewed and revised the manuscript; H.S. Lee conceptualized and designed the study, coordinated and supervised data collection and critically reviewed the manuscript; J.S. Hwang made a substantial contribution to the concept and design, acquisition of data, analysis and interpretation of data and reviewed and critically revised important intellectual content. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Cowie CC, Rust KF, Byrd-Holt DD, Gregg EW, Ford ES, et al. Prevalence of diabetes and high risk for diabetes using A1C criteria in the U.S. population in 1988–2006. Diabetes Care 2010;33:562–8.10.2337/dc09-1524Search in Google Scholar PubMed PubMed Central

2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2011;34(Suppl 1):S62–9.10.2337/dc11-S062Search in Google Scholar PubMed PubMed Central

3. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327–34.10.2337/dc09-9033Search in Google Scholar PubMed PubMed Central

4. Kwon EB, Lee HS, Shim YS, Jeong HR, Hwang JS. The changes of subtypes in pediatric diabetes and their clinical and laboratory characteristics over the last 20 years. Ann Pediatr Endocrinol Metab 2016;21:81–5.10.6065/apem.2016.21.2.81Search in Google Scholar PubMed PubMed Central

5. Barlow SE, Dietz WH. Obesity evaluation and treatment: expert committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 1998;102:E29.10.1542/peds.102.3.e29Search in Google Scholar PubMed

6. American Diabetes Association. Standards of medical care in diabetes – 2008. Diabetes Care 2008;31(Suppl 1):S12–54.10.2337/dc08-S012Search in Google Scholar PubMed

7. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33(Suppl 1):S62–9.10.2337/dc10-S062Search in Google Scholar PubMed PubMed Central

8. Buell C, Kermah D, Davidson MB. Utility of A1C for diabetes screening in the 1999–2004 NHANES population. Diabetes Care 2007;30:2233–5.10.2337/dc07-0585Search in Google Scholar PubMed

9. Lee JM, Wu EL, Tarini B, Herman WH, Yoon E. Diagnosis of diabetes using hemoglobin A1C: should recommendations in adults be extrapolated to adolescents? J Pediatr 2011;158:947–52.e1–3.10.1016/j.jpeds.2010.11.026Search in Google Scholar PubMed PubMed Central

10. Nowicka P, Santoro N, Liu H, Lartaud D, Shaw MM, et al. Utility of hemoglobin A1C for diagnosing prediabetes and diabetes in obese children and adolescents. Diabetes Care 2011;34: 1306–11.10.2337/dc10-1984Search in Google Scholar PubMed PubMed Central

11. Libman IM, Barinas-Mitchell E, Bartucci A, Robertson R, Arslanian S. Reproducibility of the oral glucose tolerance test in overweight children. J Clin Endocrinol Metab 2008;93:4231–7.10.1210/jc.2008-0801Search in Google Scholar PubMed PubMed Central

Received: 2017-11-6
Accepted: 2018-3-5
Published Online: 2018-4-13
Published in Print: 2018-5-24

©2018 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 24.4.2024 from https://www.degruyter.com/document/doi/10.1515/jpem-2017-0463/html
Scroll to top button