HBA1C analysis would not detect diabetes in adolescents

Unlike what happens in adults with diabetes, hemoglobin analysis A1C (HBA1C) in younger patients does not have the same level of determination, publishes Journal of Pediatrics.

"Given the bad performance of HBA1C analysis in children, doctors who use it for diagnosis would overlook cases of diabetes," said Dr. Joyce M. Lee.

Lee's team of the University of Michigan in Ann Arbor, explains that, traditionally, the diagnosis of diabetes mellitus - or type 1 - in adolescents and adults is carried out by measuring the fast plasma glucose (GPA) or the levelof plasma glucose at two hours of having ingested a dose of 75 grams of glucose.

But a panel of experts from the American Diabetes Association recommended to put aside those approaches and use the HBA1C.Anyway, it is unknown if the same HBA1C cut points can be applied to adults and adolescents.The recommendations were made according to studies on adults.

The team examined data from more than 1,400 patients, between 12 and 18 years, (only four had diagnostic diabetes) and more than 8,200 people from 19 to 78 years old, who had results of GPA or GP at two hours;331 adults had diagnostic diabetes.

When evaluating the effectiveness of the GPA to detect diabetes, an HBA1C of 6.5 percent had a sensitivity of 75 percent and a specificity of 99.9 percent in adolescents.

The authors emphasize that the sensitivity of 75 percent was quite unstable, and with broad intervals of trust due to the few adolescents with diabetes.

Other analysis suggested that HBA1C does not better predict diabetes mellitus in adolescents than in adults, regardless of the use of GPA or GP at two hours.HBA1C was not a good prediabetes prediabetes in adolescents either.

The authors suggest that another HBA1C threshold should be used in pediatrics."Using HBA1C to diagnose diabetes mellitus and prediabetes in adolescents would be premature to have more conclusive studies information," the team concludes.

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