Nonfasting Tests Useful for Peds Dysglycemia Screening

Random blood glucose, nonfasting glucose challenge test more reliable than HbA1c

TUESDAY, Nov. 29 (HealthDay News) -- A one-hour 50-gram nonfasting glucose challenge test (1-h GCT) and random blood glucose test are more reliable screening tools for dysglycemia (prediabetes or diabetes) in children than hemoglobin (Hb) A1c testing, according to a study published in the December issue of Diabetes Care.

Joyce M. Lee, M.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues evaluated the performance of nonfasting tests for screening of dysglycemia in 254 overweight or obese children (aged 10 to 17 years), during two scheduled visits at a clinical research unit. For the first visit, participants arrived fasting, and underwent a two-hour glucose tolerance test and HbA1c and fructosamine testing. For the second visit, the participants arrived nonfasting, and underwent a random plasma glucose test, a 1-h GCT, and a urine dipstick test. Dysglycemia (fasting plasma glucose ≥100 mg/dL or a two-hour postglucose ≥140 mg/dL) was the primary end point.

The investigators identified 99 cases of prediabetes and three cases of diabetes. Based on area under the receiver operating characteristic curve [AUC] analyses, urine dipstick, HbA1c (AUC, 0.54), and fructosamine tests (AUC, 0.55) showed poor discrimination for identifying dysglycemia. Compared to the HbA1c and fructosamine tests, better levels of test discrimination were seen with both the random glucose test and the 1-h GCT (AUC, 0.66 and 0.68, respectively).

"Random glucose or 1-h GCT may potentially be incorporated into clinical practice as initial screening tests for prediabetes or diabetes," the authors write.

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