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Screening for type 2 diabetes in obese youth
Shuchi Shah1, Bassil M Kublaoui, Jon D Oden
1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9063, USA.
Pediatrics
|July 22, 2009
Summary
Hemoglobin A1c (HbA1c) and 1,5-anhydroglucitol are effective blood tests for screening type 2 diabetes mellitus (T2DM) in obese children. Fasting blood glucose also shows promise, while HOMA-IR is less effective for T2DM prediction.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diagnostic Screening
Background:
- Obesity in children is a growing concern, increasing the risk of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM).
- Early detection of IGT and T2DM in obese children is crucial for timely intervention and management.
- Identifying reliable and accessible screening tools is essential for pediatric metabolic health surveillance.
Purpose of the Study:
- To evaluate the efficacy of various blood tests as screening tools for IGT and T2DM in obese children.
- To compare the predictive performance of fasting glucose, hemoglobin A1c (HbA1c), 1,5-anhydroglucitol, and HOMA-IR for identifying dysglycemia.
Main Methods:
- A cohort of 468 obese children underwent oral glucose-tolerance testing.
- Fasting blood samples were analyzed for glucose, insulin, HbA1c, and 1,5-anhydroglucitol (in an insulin-resistant subgroup).
- Receiver operator characteristic (ROC) curves were used to assess the screening efficacy of different biomarkers.
Main Results:
- In the insulin-resistant subgroup, HbA1c (>or= 6.0%) and 1,5-anhydroglucitol (< 17.0 microg/mL) demonstrated high sensitivity and specificity for T2DM detection.
- In the entire cohort, HbA1c (5.7%) and fasting blood glucose (104 mg/dL) showed good predictive values for T2DM.
- HOMA-IR exhibited lower sensitivity and specificity compared to HbA1c and fasting glucose.
Conclusions:
- HbA1c, 1,5-anhydroglucitol, and fasting blood glucose are valuable predictors for T2DM in obese children.
- HOMA-IR is not a reliable screening tool for T2DM in this population.
- HbA1c and 1,5-anhydroglucitol are particularly effective for screening T2DM in insulin-resistant obese children.
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