The number of kids with diabetes has skyrocketed in recent years, and the U.S. Centers for Disease Control now estimates that 2.5 million children should be screened for the disease. To make that screening easier, the American Diabetes Association in 2009 recommended a test called the Hemoglobin A1c – which doesn’t require overnight fasting – as the exclusive diabetes test for children.
But a new study from researchers at Michigan’s C.S. Mott Children’s Hospital found that method fails to identify as many as two thirds children with diabetes. Testing 254 overweight children, the study looked at the following methods:
• 1-hour glucose challenge test, where the patient doesn’t have to fast, drinks 50gm of a sugary substance and has their glucose drawn 1 hour later
• Random glucose, where the patient has glucose drawn without having to fast
• Hemoglobin A1c, a test that measures blood glucose 2 hours after the patient eats
• Fasting glucose, where the patient does not eat or drink for 8-12 hours before testing
• 2-hour glucose tolerance test, where the patient may not eat or drink for 8-12 hours, drinks 75gm of a sugary substance, and has glucose drawn two hours later
“We found that a 1-hour glucose challenge test or a random glucose were the best tests for identifying which kids have prediabetes or diabetes,” says pediatric endocrinologist Joyce M. Lee, M.D., lead author of the study. “We also looked at hemoglobin A1c, which has recently been advocated as a test for diabetes in children and adults, and found that it had poor test performance.”
Lee says that fasting glucose and the 2-hour glucose tolerance test remain the “gold standard for defining prediabetes or diabetes,” but because it’s inconvenient to have kids return for a second office visit for a blood draw, she and colleagues decided to evaluate the nonfasting tests – 1-hour glucose, random glucose and hemoglobin A1c.
Because their study found that hemoglobin A1c missed two of three children that the fasting tests identified as having diabetes or prediabetes, the researchers are urging that the 1-hour glucose or random glucose tests be used in kids instead.
Looks like drinking coffee might offer protection against endometrial cancer, which killed more than 8,000 U.S. women this year according to the National Cancer Institute. But you’ve got to drink lots. Harvard researchers looked at more than 67,000 women enrolled in the Nurses’ Health Study, analyzing 26 years of follow-up data.
News out today from the American Academy of Pediatrics (AAP) highlights a range of vaccine-related issues.
Got prescriptions, but can’t remember to take them? Or can’t remember to take them at the same time every day? Plastic pill organizers will help you notice you’ve missed a dose, but what you really need is someone to tap you on the shoulder and say, “Hey, take your meds.”
While 89 percent of parents understand that putting babies to sleep on their backs, in a crib with a firm mattress and no pillows or toys is safest, 40 percent say they believe it is safe for babies to sleep in the same bed as someone else.
To be really smart about antibiotics, you have to know the difference between a bacterial infection (like strep throat) and a viral infection (like a cold or the flu). Antibiotics work great for one, but are useless against the other.
Heart disease is rare in children, but risk factors that develop in childhood can make it much more likely cardiovascular problems will show up in adulthood. That’s why new expert guidelines recommend all children be screened for high cholesterol at least once between ages 9 and 11.
There is a well-established connection between depression in mothers and emotional and behavior problems in kids. The connection between a father’s mental health and his children’s well-being has received less attention.
