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Blood testing to diagnose Diabetes in Obese Youth

The youth of today are getting bigger and heavier, and this is no sign of health. Obesity comes with many chronic comorbidities including diabetes. This is why a study recommended mandatory blood testing among obese youth for the early detection of type 2 diabetes.

Dr. Shuchi Shah of the University of Texas Southwestern Medical Center in Dallas moves for compulsory fasting blood glucose, hemoglobin A1c (HbA1c), and 1.5-anhydrogluticol blood testing among obese youth. “Easily implemented screening tests for type 2 diabetes mellitus in children would facilitate early intervention,” Dr. Shah and her colleagues explained in the study. “Although at least three such tests have been examined in adults they have not been systematically compared in obese children.”

The researchers tried to compare HbA1c, 1,5-anhydroglucitol, fasting blood glucose, and a measure of insulin resistance for their efficacy in identifying patients with type 2 diabetes and impaired glucose tolerance. In addition, patients also had an oral glucose-tolerance test for measurement of 2-hour postload serum glucose and insulin levels.

Using the data gathered, the researchers were able to diagnose type 2 diabetes in 9 patients, impaired glucose tolerance in 44 patients. They were also able to rate the optimal sensitivity and specificity, respectively, 86% and 85% at HbA1c levels of 5.7%; 88%, and 93% at a fasting blood glucose level of 104 mg/dL; and 62% and 70% at a HOMA-IR of 7.9.

“HbA1c, 1, 5-anhydroglucitol, and fasting blood glucose levels are good predictors of T2DM in obese children, whereas HOMA-IR values are not,” the study authors explained. “HbA1c and 1, 5-anhydroglucitol are excellent predictors of T2DM in insulin-resistant obese children.”

However, the researchers admitted to the difficulty with standardization of HbA1c assays discussed previously. “Particular caution is urged in using the data in the present study to guide therapeutic decisions on the basis of HbA1c values obtained in the community,” the study authors concluded.

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