Current testing measures may miss many children at risk for type 2 diabetes

An early diagnosis of type 2 diabetes can play an important role in successfully treating the condition, but researchers from Children's Mercy Hospitals and Clinics have found that standard testing measures may be insufficient for diagnosing the condition in obese children.

The team reported at the recent Annual Meeting of the Pediatric Academic Societies that simply providing overweight young people with HbA1c testing, as is commonly recommended, may overlook two-thirds of children who are at risk of developing type 2 diabetes.

The American Diabetes Association currently recommends only HbA1c testing because it can assess an individual's long-term blood sugar levels and does not require a person to fast beforehand, making it easier on patients. However, the team found that this method on its own is ineffective and should be combined with oral glucose tolerance testing.

For the study, the researchers examined the medical records of 629 overweight adolescents who had received both testing methods. The results showed that 40 percent of patients who had type 2 diabetes and 67 percent of high-risk patients - as determined by oral glucose tolerance testing - had normal HbA1c scores.

The researchers said that their findings have major implications, as allowing the condition to progress untreated can cause major damage to the body and prevent individuals from making adjustments that could help them resolve their diabetes.

"Lifestyle changes and early treatment can help delay disease progression of diabetes," said Dr. Wayne Moore, chief medical director of the endocrine and diabetes section at the hospital and co-author of the study. "It is important that patients are diagnosed as early as possible for the best outcomes."

Even relatively small lifestyle changes may be enough to help individuals with pre-diabetes avoid developing the full condition. The National Institute of Diabetes and Digestive and Kidney Diseases reports that studies have shown losing just five to seven percent of one's body mass index may be sufficient to prevent pre-diabetes from progressing to type 2 diabetes.

The agency urges individuals who are overweight or obese to consider starting a low-calorie, low-fat diet and incorporating brisk physical activity into their daily routines.

The fact that type 2 diabetes can be averted underscores the importance of accurate testing. The researchers at Children's Mercy Hospitals and Clinics said that obese young people should be given special attention during physical examinations in order to ensure that those at risk have a chance to avoid diabetes.