A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Introduction. The incidence and prevalence of Type 2 diabetes mellitus has been steadily
increasing over the past ten years, and is currently approximately 4.1 per 1000 12‐19 year olds
in the US2. This increase has been linked to obesity and a sedentary lifestyle. Prediabetes, in
the pediatric population is defined as having a fasting plasma glucose concentration ≥ 100 to
125 mg/dL or 2‐hour glucose concentration during an oral glucose tolerance test ≥ 140 mg/dL
but <200 mg/dL.
Aims. The goal of this study is to describe the sensitivity and specificity of hemoglobin A1c at
various thresholds to identify prediabetes, as defined by impaired fasting glucose and/or
impaired glucose tolerance; the population included in this study consist of obese youth
referred to the Division of Endocrinology and Diabetes at Phoenix Children’s Hospital for
weight‐related issues. We anticipate describing various levels of sensitivity and specificity of
hemoglobin A1c in comparison with gold standard tests, such that it can be used to propel
further studies to ultimately reduce the immense patient burden of fasting in the pediatric
population.
Methods. We conducted a retrospective cross‐sectional chart review and employed receiver
operating characteristic (ROC) curve analysis of data including but not limited to hemoglobin
A1c, fasting plasma glucose, and 2‐hr post‐prandial plasma glucose. The benefits of this study
include the potential of reducing the patient burden of fasting prior to examination. This
review will determine, if any, the potential value in being able to use hemoglobin A1c clinically
to detect prediabetes in pediatric patients; determining this may provide critical information to
improve the monitoring and screening of prediabetes.
Conclusions. Compared to the gold standards of fasting plasma glucose and oral glucose
tolerance tests, we found that hemoglobin A1c had a low sensitivity and specificity for
identifying prediabetes.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/603681 |
| Date | 25 March 2016 |
| Creators | Srivastava, Sarika |
| Contributors | The University of Arizona College of Medicine - Phoenix, McClellan, Donald MD |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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