Method for Pre-Diabetes Screening in Obese Children Needs to Change

MedPage Today is reporting a study finding that many obese children with pre-diabetes will NOT be recogninzed using current testing technique – a fasting plasma glucose only.

Even scarier is the fact that nearly a quarter (24.3%) of the 173 obese children screened positive for pre-diabetes according to fasting plasma glucose AND a two-hour oral glucose tolerance test. While only 8.7% of the obese children were found to be pre-diabetic using fasting plasma glucose alone.

My Take?

This will change my practice.

Currently, both the American Diabetes Association and the Canadian equivalent recommend screening for pre-diabetes (dysglycemia) in obese children ages 10 and older (all of whom are at risk for type 2 diabetes) with the fasting plasma glucose.

I would agree with the conclusion of the researchers: “If you’re going to do a sugar test, you should do a two-hour test.”

In what MedPage describes as a new and surprising finding, “the prevalence of pre-diabetes in the study was similar in children younger than 10 (20.8%) and in those 10 and older (25.8%). Screening is typically not done in younger children.”

Note that this study was published as a poster at a conference. Therefore, these data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

 

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