HbA1c test identifies young at risk of type 2

The simple HbA1c blood test that does not require overnight fasting has been found to be an accurate screening tool for identifying young people at risk for type 2 diabetes and heart disease risk later in life.

Researchers at the Johns Hopkins Bloomberg School of Public Health said their study indicated that the hemoglobin A1c (HbA1c), could be used to screen youth for diabetes and related health risks.

The HbA1c test is accurate and easy to administer in younger patients.

About the study

For the study, published online August 10 in Pediatrics, the researchers analyzed national survey and medical exam data on more than 14,000 youth ages 10 to 19.

One aim was to see how closely a positive result on different tests for high blood glucose is related to risk factors for diabetes and heart disease such as obesity and high blood cholesterol.

The researchers found that hyperglycemia as defined by the HbA1c test was strongly associated with these cardiometabolic risk factors, compared to hyperglycemia defined by the traditional fasting glucose test.

Among youth with HbA1c-defined hyperglycemia, for example, 51 percent were obese, compared to just 29 percent of youth with hyperglycemia defined by the fasting glucose test.

The HbA1c test measures the degree to which glucose molecules have linked irreversibly to molecules in red blood cells in the previous few months. This makes it an accurate marker of chronic hyperglycemia. The HbA1c test, however, does not require compliance with overnight fasting before the test, and thus–compared to the fasting plasma glucose test–is less complicated to administer and can be less prone to error.

The results

Our study demonstrates that HbA1c is a useful non-fasting test for identifying high-risk youth who could benefit from lifestyle interventions to prevent diabetes and cardiovascular disease later in life.”

Elizabeth Selvin, PhD, MPH, study senior author, professor in the Bloomberg School’s Department of Epidemiology

While type 2 diabetes, which is far more common in adults, it is becoming more common in children, as rates of obesity, poor diet, and sedentary lifestyles increase.

That trend has led researchers to emphasize early diabetes detection and lifestyle intervention in youth to reduce or even reverse hyperglycemia–thus helping prevent a lifetime of diabetes and associated medical complications, which can include heart disease, stroke, hypertension, and kidney disease.

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