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Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia

OBJECTIVE: To assess performance of nonfasting tests to screen children for dysglycemia (prediabetes or diabetes). RESEARCH DESIGN AND METHODS: This was a cross-sectional study of 254 overweight or obese (BMI ≥85th percentile) children aged 10–17 years. Subjects came for two visits to a clinical res...

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Autores principales: Lee, Joyce M., Gebremariam, Achamyeleh, Wu, En-Ling, LaRose, Jennifer, Gurney, James G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220868/
https://www.ncbi.nlm.nih.gov/pubmed/21953800
http://dx.doi.org/10.2337/dc11-0827
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author Lee, Joyce M.
Gebremariam, Achamyeleh
Wu, En-Ling
LaRose, Jennifer
Gurney, James G.
author_facet Lee, Joyce M.
Gebremariam, Achamyeleh
Wu, En-Ling
LaRose, Jennifer
Gurney, James G.
author_sort Lee, Joyce M.
collection PubMed
description OBJECTIVE: To assess performance of nonfasting tests to screen children for dysglycemia (prediabetes or diabetes). RESEARCH DESIGN AND METHODS: This was a cross-sectional study of 254 overweight or obese (BMI ≥85th percentile) children aged 10–17 years. Subjects came for two visits to a clinical research unit. For visit one, they arrived fasting and a 2-h glucose tolerance test and HbA(1c) and fructosamine testing were performed. For visit two, they arrived nonfasting and had a random plasma glucose, a 1-h 50-g nonfasting glucose challenge test (1-h GCT), and urine dipstick performed. The primary end point was dysglycemia (fasting plasma glucose ≥100 mg/dL or a 2-h postglucose ≥140 mg/dL). Test performance was assessed using receiver operating characteristic (ROC) curves and calculations of area under the ROC curve. RESULTS: Approximately one-half of children were female, 59% were white, and 30% were black. There were 99 (39%) cases of prediabetes and 3 (1.2%) cases of diabetes. Urine dipstick, HbA(1c) (area under the curve [AUC] 0.54 [95% CI 0.47–0.61]), and fructosamine (AUC 0.55 [0.47–0.63]) displayed poor discrimination for identifying children with dysglycemia. Both random glucose (AUC 0.66 [0.60–0.73]) and 1-h GCT (AUC 0.68 [0.61–0.74]) had better levels of test discrimination than HbA(1c) or fructosamine. CONCLUSIONS: HbA(1c) had poor discrimination, which could lead to missed cases of dysglycemia in children. Random glucose or 1-h GCT may potentially be incorporated into clinical practice as initial screening tests for prediabetes or diabetes and for determining which children should undergo further definitive testing.
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spelling pubmed-32208682012-12-01 Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia Lee, Joyce M. Gebremariam, Achamyeleh Wu, En-Ling LaRose, Jennifer Gurney, James G. Diabetes Care Original Research OBJECTIVE: To assess performance of nonfasting tests to screen children for dysglycemia (prediabetes or diabetes). RESEARCH DESIGN AND METHODS: This was a cross-sectional study of 254 overweight or obese (BMI ≥85th percentile) children aged 10–17 years. Subjects came for two visits to a clinical research unit. For visit one, they arrived fasting and a 2-h glucose tolerance test and HbA(1c) and fructosamine testing were performed. For visit two, they arrived nonfasting and had a random plasma glucose, a 1-h 50-g nonfasting glucose challenge test (1-h GCT), and urine dipstick performed. The primary end point was dysglycemia (fasting plasma glucose ≥100 mg/dL or a 2-h postglucose ≥140 mg/dL). Test performance was assessed using receiver operating characteristic (ROC) curves and calculations of area under the ROC curve. RESULTS: Approximately one-half of children were female, 59% were white, and 30% were black. There were 99 (39%) cases of prediabetes and 3 (1.2%) cases of diabetes. Urine dipstick, HbA(1c) (area under the curve [AUC] 0.54 [95% CI 0.47–0.61]), and fructosamine (AUC 0.55 [0.47–0.63]) displayed poor discrimination for identifying children with dysglycemia. Both random glucose (AUC 0.66 [0.60–0.73]) and 1-h GCT (AUC 0.68 [0.61–0.74]) had better levels of test discrimination than HbA(1c) or fructosamine. CONCLUSIONS: HbA(1c) had poor discrimination, which could lead to missed cases of dysglycemia in children. Random glucose or 1-h GCT may potentially be incorporated into clinical practice as initial screening tests for prediabetes or diabetes and for determining which children should undergo further definitive testing. American Diabetes Association 2011-12 2011-11-14 /pmc/articles/PMC3220868/ /pubmed/21953800 http://dx.doi.org/10.2337/dc11-0827 Text en © 2011 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Lee, Joyce M.
Gebremariam, Achamyeleh
Wu, En-Ling
LaRose, Jennifer
Gurney, James G.
Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia
title Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia
title_full Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia
title_fullStr Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia
title_full_unstemmed Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia
title_short Evaluation of Nonfasting Tests to Screen for Childhood and Adolescent Dysglycemia
title_sort evaluation of nonfasting tests to screen for childhood and adolescent dysglycemia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220868/
https://www.ncbi.nlm.nih.gov/pubmed/21953800
http://dx.doi.org/10.2337/dc11-0827
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