Sci Tech

HbA1c diabetes blood test not as effective for children

The haemoglobin A1c (HbA1c) test has become the preferred way to diagnose diabetes among the millions of Americans who have diabetes but show no symptoms. the simple test measures longer-term blood sugar levels — without requiring patients to fast overnight.

Not best way

But a study by the University of Michigan’s C.S. Mott Children’s Hospital shows it’s not the best way to diagnose diabetes in children.

But U-M researchers say more study is needed before doctors can safely rely on using haemoglobin A1c for children.

“we found that haemoglobin A1c is not as reliable a test for identifying children with diabetes and pre-diabetes compared with adults,” says study lead author Joyce M. Lee, a paediatric endocrinologist at Mott Children’s Hospital. “using this test in children may lead to missed cases.”

The study was published online ahead of print in Journal of Pediatrics and provides new insight on effectively diagnosing diabetes in children.

In 2010, the American Diabetes Association released guidelines recommending HbA1c be exclusively used for diagnosing diabetes in children and adults.

For the study, Mott researchers evaluated the testing results of 1,156 obese and overweight adolescents, ages 12-18. the ADA recommends screening only obese and overweight kids because their weight puts them at higher risk for developing diabetes.

According to the guidelines, individuals without symptoms would be classified as having diabetes if HbA1c values reach 6.5 percent and as having pre-diabetes if HbA1c values reached between 6 and 6.4 percent on two separate tests.

According to a University of Michigan press release, the cut-off point may need to be lower for kids.

Until more definitive studies are available, it’s premature to use HbA1c for children, authors say. — our Bureau

Printer friendly page   Send this article to Friends by E-Mail

Sci Tech

When we think of November, Thanksgiving dinners, pumpkins, and fall foliage immediately come to mind. November is also National Diabetes Awareness Month, a time dedicated to educating Americans about a disease that affects 1 in 10 adults in the United States — and whose prevalence is projected to to climb to a frightening 1 in 3 US adults by 2050, according to the Centers for Disease Control and Prevention.

Diabetes is a metabolic disease that involves abnormalities in insulin production and/or sensitivity to the effects of insulin.  Insulin is a hormone produced by the pancreas that’s required for cells throughout the body to be able to take up sugar from the blood stream to use for their own energy needs.

DID YOU KNOW

• Currently, Diabetes is the leading cause of blindness in the U.S., accounting for 12,000-24,000 new cases per year
• Diabetes is the 7th leading cause of death
• Diabetes is the foremost cause of kidney failure, accounting for 44% of new cases in 2005.
• In number terms, it affects 23.6 million children and adults which is 7.8% of the total population.
• 57 million Americans have a condition called “pre-diabetes” that can develop into full-fledged Diabetes unless diet and exercise-related lifestyle changes are made.

Because obesity is a risk factor for developing Diabetes, as our nation’s collective weight continues to increase, so do incidence rates of Diabetes. Other complications associated with diabetes include visual impairment, nerve damage, poor circulation in the hands and feet that may lead to amputations, sexual dysfunction and skin issues.  Diabetes can also put you at a higher risk for heart disease and bone and joint disorders.

TYPES OF DIABETES Though Diabetes Mellitus is the general name for the disease, there are actually three different types of this metabolic disorder. 

Diabetes Type 1, formerly called “juvenile diabetes” or “insulin dependent diabetes,” is usually diagnosed in children, teenagers or young adults, but can also occur later in life. Diabetes Type 1 only accounts for about 5% of all Diabetes cases.  This type of Diabetes is an autoimmune disease of the pancreas, where the body’s immune system attacks and destroys the cells responsible for making insulin. People with Type 1 Diabetes must take insulin shots or wear an insulin pump to substitute for the missing insulin from their pancreas.

Diabetes Type 2, the most common form among Americans, is also referred to as “noninsulin dependent diabetes,” or “adult onset” Diabetes, though the latter term is misleading since its prevalence is on the rise among children. In this form, the pancreas still produces insulin, however insulin resistance occurs causing glucose to accumulate in the blood rather than get taken up by the cells. People at risk for type 2 diabetes include those who are overweight or obese, inactive, people with family history, low HDL, high blood pressure, high triglycerides, women who had Gestational Diabetes during pregnancy, or who had a baby weighing 9 lbs or more at birth, and certain racial and ethnic groups.

Gestational Diabetes occurs in women who are pregnant. about 3 – 10% of pregnant women develop gestational diabetes. It usually only spans the length of pregnancy, though can put women at risk for developing diabetes later in life.

SYMPTOMS OF DIABETES

• Frequent urination
• Blurred vision
• Unusual thirst
• Involuntary weight loss
• Recurring skin, gum, or bladder infection
• Tingling or numbness in hands and feet.

Be aware that people living with diabetes can also be asymptomatic, so routine doctor visits are important to screen your blood and be evaluated for risk factors.

To learn more about diabetes, please visit the American Diabetes Association website.

Living in Alachua County, we are more than 40 percent more likely to die of diabetes than residents in the rest of Florida. the odds are worse if we’re African American. between 2006 and 2008, the age-adjusted death rate from diabetes was 155 percent higher for black residents than for white residents.

Those figures are part of the 2010 Alachua County Health Needs Assessment. And the no. 1 factor behind the numbers? Obesity.

A report last week from the UnitedHealth Center for Health Reform & Modernization states than more than half of all Americans will have diabetes or pre-diabetes by 2020.

The health care costs of the diabetes epidemic could reach $3.35 trillion if current trends continue, the report warns.

We are growing fatter, and with obesity comes a phalanx of chronic health problems, including Type 2, or noninsulin-dependent diabetes.

The average health care costs in 2009 for a person with known diabetes totaled $11,700, compared to an average of $4,400 for the remainder of the population, United HealthCare reports.

Fortunately, diabetes is also one of those problems for which there is a solution. while there’s no cure, diabetes can be managed. Early screening helps. Healthier diets and more physical exercise are the two keys to controlling its potential health impacts, which are many and serious: heart attack, stroke, blindness, amputations and kidney failure.

Diabetes educators point out that there are two types of diabetes. Type 1 is an autoimmune disorder, genetically linked, in which the body attacks itself and destroys the cells in the pancreas that make insulin. People with this condition are usually diagnosed young and must receive insulin to live.

Type 2, or adult-onset diabetes, is reaching near-epidemic proportions. Obesity is a major risk factor, and those with it have trouble putting insulin to use in the body to metabolize dietary sugars. Type 2 diabetics face more complications, including high blood pressure, high cholesterol, heart disease and stroke.

Common symptoms include frequent urination, excessive thirst, extreme hunger, unusual weight loss or gain, increased fatigue, irritability, blurred vision and frequent infections.

With this type of diabetes, experts’ advice is simple: move more. Eat less.

However, as Diane Dimperio of the Alachua County Health Department points out, it isn’t always easy to follow that advice. Food temptation is everywhere, especially over the holidays. You may feel too rushed to fit regular exercise into your daily schedule. You may be the only one in the family cutting back on sweets and sodas.

There are local programs that can help, Dimperio said.

At the Alachua County Health Department, primary care specialists assist with medical management of your disease. There is also an enhanced program for diabetes management headed by an exercise physiologist for diabetics who come through the clinic. for some, the program provides free glucose testing strips.

“We are starting to acquire data to measure the success of this program,” Dimperio said, “but on a case-by-case basis, I can say we’ve seen a huge improvement.

Then there’s the CHOICES health education and wellness program, which offers exercise and nutrition classes in a group setting.

Participants don’t have to be enrolled in CHOICES to participate and classes are held “all over the county,” Dimperio said. Exercise options range from zumba and kickboxing to senior exercise, sports conditioning and pilates.

Here are some general tips worth following:

Lose weight if you are overweight.

Eat small, frequent meals to maintain blood sugars within healthy range.

Keep refined starches and sugars to a minimum.

Minimize consumption of saturated fats and trans-fats.

Eat lots of vegetables.

Increase your activity level. Aim for 30 minutes a day

“Take control; don’t be a statistic,” Dimperio said.