Recently HbA1c test has been approved for diagnosis of both T1 and T2 Diabetes. But a new study by the University of Michigan's C.S. Mott Children's Hospital concludes that it is not the best way to diagnose diabetes in children. Cut-off point may need to be lower for kids, to avoid missing the diagnosis of diabetes.

     "We found that haemoglobin A1c is not as reliable a test for identifying children with diabetes and pre-diabetes compared with adults," says study lead author Joyce M. Lee, a paediatric endocrinologist at Mott Children's Hospital. "Using this test in children may lead to missed cases."

     According to ADA guidelines (American Diabetes Association) HbA1c can be used for diagnosing diabetes in children and adults.
For the study, Mott researchers evaluated the testing results of 1,156 obese and overweight adolescents, ages 12-18. The ADA recommends screening only obese and overweight kids because their weight puts them at higher risk for developing diabetes.

     According to the guidelines, individuals without symptoms would be classified as having diabetes if HbA1c values reach 6.5 percent and as having pre-diabetes if HbA1c values reach between 6 and 6.4 percent on two separate tests. The U-M authors suggest that the cut-off point may need to be lower for kids.

     Until more definitive studies are available, it is premature to use HbA1c for children, authors say. Other tests such as the fasting plasma glucose and 2-hour plasma glucose measurements have long been relied on by doctors to diagnose diabetes among adults and children, but, as HbA1c emerged, they were expected to be phased out of use.