The number of Type 2 diabetes cases is growing along with the waistlines of Americans. However, a University of Michigan study found new American Diabetes Association (ADA) screening guidelines may lead to the missed diagnoses of type 2 diabetes in children.
“This potential for increased uptake of HbA1c could lead to missed cases pre-diabetes and diabetes in children, and increased costs,” said lead author Joyce Lee, M.D., M.P.H. in a press release.
In 2010, the ADA recommended physicians use Hemoglobin A1c screening tests, rather than glucose tests to identify children and adults with pre-diabetes and diabetes.
This change has been controversial because of lower test performance of HbA1c in children compared to adults.
“A number of studies have shown that HbA1c has lower test performance in pediatric compared with adult populations, and as a result, increased uptake of HbA1c alone or in combination with non-fasting tests could lead to missed diagnoses of type 2 diabetes in the pediatric population,” said Lee. “Also, a recent analysis of screening strategies found that HbA1c is much less cost-effective than other screening tests, which would result in higher overall costs for screening.”
During the study, researchers surveyed a group of physicians from pediatrics and family practice across the nation.
They found 84 percent of physicians reported they would switch from using glucose tests to using HbA1c tests when given the ADA screening guidelines.
“Greater awareness of the 2010 ADA guidelines will likely lead to increased uptake of HbA1c and a shift to use of non-fasting tests to screen for adolescents with type 2 diabetes. This may have implications for detection rates for diabetes and overall costs of screening,” said Lee.
The new findings are published in the Journal of Adolescent Health.
