HbA1c and the Prediction of Type 2 Diabetes in Children and Adults

Abstract

OBJECTIVELong-term data validating glycated hemoglobin (HbA1c) in assessing the risk of type 2 diabetes in children are limited. HbA1c, fasting plasma glucose (FPG), and 2-h postload plasma glucose (2hPG) concentrations were measured in a longitudinal study of American Indians to determine their utility in predicting incident diabetes, all of which is thought to be type 2 in this population.RESEARCH DESIGN AND METHODSIncident diabetes (FPG ≥126 mg/dL [7.0 mmol/L], 2hPG ≥200 mg/dL [11.1 mmol/L], HbA1c ≥6.5% [8 mmol/mol], or clinical diagnosis) was determined in 2,095 children without diabetes ages 10–19 years monitored through age 39, and in 2,005 adults ages 20–39 monitored through age 59. Areas under the receiver operating characteristic (ROC) curve for HbA1c, FPG, and 2hPG in predicting diabetes within 10 years were compared.RESULTSDuring long-term follow-up of children and adolescents who did not initially have diabetes, the incidence rate of subsequent diabetes was fourfold (in boys) as high and more than sevenfold (in girls) as high in those with HbA1c ≥5.7% as in those with HbA1c ≤5.3%—greater rate ratios than experienced by adults in the same HbA1c categories. Analyses of ROCs revealed no significant differences between HbA1c, FPG, and 2hPG in sensitivity and specificity for identifying children and adolescents who later developed diabetes.CONCLUSIONSHbA1c is a useful predictor of diabetes risk in children and can be used to identify prediabetes in children with other type 2 diabetes risk factors with the same predictive value as FPG and 2hPG.

Peri‐implant soft tissue status and crestal bone levels around adjacent implants placed in patients with and without type‐2 diabetes mellitus: 6 years follow‐up results

“…First, it is noteworthy that all individuals in Group-1, despite having medically diagnosed type-2 diabetes had glycemic levels within the normal range, that is HbA1c levels below 5.5% 18. The present results must be construed with attention as a number of factors may have influenced the reported results.…”

Relationship between fasting plasma glucose and incidence of diabetes in children and adolescents

“…While most previous studies have explored the predictive value of childhood cardiometabolic risk factors only for the development of adult-onset diabetes [9,26,27,29], a recent study investigated the use of childhood glucose haemostasis variables in predicting incident diabetes (either childhood-or adult-onset) [28]. While most previous studies have explored the predictive value of childhood cardiometabolic risk factors only for the development of adult-onset diabetes [9,26,27,29], a recent study investigated the use of childhood glucose haemostasis variables in predicting incident diabetes (either childhood-or adult-onset) [28].…”

“…Among these, prediabetes is associated with increased incidence of diabetes and cardiovascular disease [12,[17][18][19][20][21]. Some studies have investigated whether prediabetes in children is associated with a higher risk of subsequent diabetes [9,[26][27][28][29]. Some studies have investigated whether prediabetes in children is associated with a higher risk of subsequent diabetes [9,[26][27][28][29].…”

“…Some studies have investigated whether prediabetes in children is associated with a higher risk of subsequent diabetes [9,[26][27][28][29]. A recent study showed that FPG ≥ 5.6 mmol/l, 2-h postloading plasma glucose ≥ 7.8 mmol/l and HbA 1c ≥ 39 mmol/ mol (5.7%) were useful predictors of diabetes risk in children [28]. A recent study showed that FPG ≥ 5.6 mmol/l, 2-h postloading plasma glucose ≥ 7.8 mmol/l and HbA 1c ≥ 39 mmol/ mol (5.7%) were useful predictors of diabetes risk in children [28].…”

Cardiovascular risk factors in adolescents with prediabetes

“…Children and adults with prediabetes have elevated blood glucose levels that are close to but below the cut-off point for diagnosing diabetes, indicating a higher risk of developing diabetes than those with normal glucose levels [1,2]. Among adults, those with prediabetes have a higher risk of cardiovascular disease (CVD) than those with normal glucose levels [3].…”