Diabetes Screening in Children Predicts Future Complications

By Patrick Daly - Last Updated: June 29, 2023

According to an American Diabetes Association (ADA) press release, the United States has seen a significant increase in obesity-induced, youth-onset type 2 diabetes, leading the ADA to recommend diabetes screening in asymptomatic children who are overweight or obese. Whether this screening has been effective for predicting long-term outcomes based on childhood assessments was unclear, however.

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Researchers investigated a cohort of American Indian children—a population with twice the incidence of diabetes compared with White populations—to determine if blood glucose levels during childhood were associated with future diabetes-related complications. They presented their findings at the 83rd Scientific Sessions of the ADA and published them in Diabetes Care.

Researchers reviewed more than 4 decades of data from a longitudinal observational study in an American Indian community in the southwestern United States and reported that higher levels of glycemia during childhood examinations were significantly associated with future microvascular complications, including kidney and eye disease.

Future Kidney and Eye Disease Linked to Childhood Blood Glucose

“This study sheds light on how pediatric screenings are a critically important guideline,” said Dr. Robert Gabbay, chief scientific and medical officer for the ADA. “Furthermore, the findings will help inform evidence-based recommendations to ensure better care for all people with diabetes, including vulnerable communities and those at high risk.”

Variables of interest included glycated hemoglobin (HbA1c) and 2-hour post-load plasma glucose among patients aged 5 to 19 years with future albuminuria (albumin creatinine ratio [ACR] ≥30 mg/g), severe albuminuria (ACR ≥300 mg/g), and retinopathy (≥1 microaneurysm, hemorrhage, or proliferative retinopathy on direct ophthalmoscopy).

Specifically, the study found that higher levels of HbA1c and 2-hour post-load plasma glucose during childhood were significantly associated with development of retinopathy in the future.

Additionally, the risk for albuminuria and severe albuminuria was positively correlated with baseline HbA1c levels in children with type 2 diabetes compared with those with prediabetes and normal glucose levels.

“These findings underscore the value of glycemic screening tests in high-risk children at a time when obesity and diabetes risk factors are disproportionately impacting at-risk communities,” concluded Madhumita Sinha, MD, FAAP, assistant clinical investigator and head of the Diabetes Epidemiology and Clinical Research Section for the National Institutes of Health.

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