What’s the Best Test for Children’s Diabetes?
Study Suggests HbA1C Blood Test Doesn’t Work as Well in Kids as Adults
Comparing Diabetes Screening Tests continued...
The researchers also compared results in a subset of 267 adolescents and 1,476 adults who had two-hour plasma glucose measurements, in which blood glucose is measured exactly two hours after you have a sweet drink. The two-hour test was also more sensitive than the HbA1c test in adolescents.
“Most of the studies that were done to validate the HbA1c were done in adults,” Lee says. There are hormonal differences in children that may affect its ability to diagnose diabetes, she says. “There is also an age-dependent rise in HbA1c over time, so we many need a lower threshold.”
Gerald Bernstein, MD, director of the diabetes management program at the Friedman Diabetes Institute of Beth Israel Medical Center in New York City, agrees that the HbA1c test results can be misleading in children. He says that changing hormone levels in boys and girls may skew the results.
“There is a lot of data that needs to be accumulated and validated in the technical sense to be able to use this test as reliable diagnostic criteria," he says.
“If your child is at risk for diabetes, I would not be happy with just this test unless it was high,” he says. “If it was high, you escape the ambiguousness seen in the new study.”
Glucose tolerance is still the gold standard, he says.