New guidelines for diabetes could under diagnose children

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A policy switch from the American Diabetes Association (ADA) may miss diagnoses in children with diabetes or pre-diabetes, according to a study from the University of Michigan.

Recently the ADA changed their recommendation for testing adults and children for diabetes from glucose tests to Hemoglobin A1c tests, even though the Hemoglobin tests have a lower performance for children compared to adults. Researchers found 84 percent of physicians would switch to the Hemoglobin test when presented with the ADA’s new guidelines. They also found the test is much less cost-effective than the glucose tests.

"Greater awareness of the 2010 ADA guidelines will likely lead to increased uptake of HbA1c and a shift to use of non-fasting tests to screen for adolescents with type 2 diabetes,” lead author Joyce Lee, MD, MPH, was quoted as saying. "This potential for increased uptake of HbA1c could lead to missed cases pre-diabetes and diabetes in children, and increased costs.”

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