Study challenges use of diabetes test on children

DETROIT — A commonly used blood glucose test may not be the best way to diagnose diabetes in children, according to a new University of Michigan study released Wednesday.

Guidelines from the American Diabetes Association published last year recommend the hemoglobin A1c test, which measures longer-lasting blood-sugar levels in the blood, to diagnose diabetes in children and adults. The test is convenient because it does not require overnight fasting.

But University of Michigan researchers analyzing A1c test results of 1,156 overweight children, adolescents and teens found that the test was not always reliable and missed finding the condition in some children, said Dr. Joyce Lee, a pediatric endocrinologist at the university's C.S. Mott Children's Hospital in Ann Arbor, Mich.

"I don't think the A1c test alone should be used as a diagnostic test in children," Lee said in a telephone interview. The test particularly missed finding children who had a prediabetic condition, she said. She recommends that children also be given tests known as fasting or two-hour glucose tests.

The diabetes association guidelines say a person is diabetic if A1c values reach 6.5 percent and prediabetic if the numbers are between 6 percent and 6.4 percent on two separate tests.

Lee said the values may need to be lower for children.

The study was published in the online edition of the Journal of Pediatrics.