Hemoglobin A1c is a reliable criterion for diagnosing type 1 diabetes in childhood and adolescence
Version of Record online: 8 FEB 2010
© 2010 John Wiley & Sons A/S
Volume 11, Issue 7, pages 446–449, November 2010
How to Cite
Ehehalt, S., Gauger, N., Blumenstock, G., Feldhahn, L., Scheffner, T., Schweizer, R., Neu, A. and for the DIARY-Group Baden-Wuerttemberg (2010), Hemoglobin A1c is a reliable criterion for diagnosing type 1 diabetes in childhood and adolescence. Pediatric Diabetes, 11: 446–449. doi: 10.1111/j.1399-5448.2009.00633.x
- Issue online: 8 FEB 2010
- Version of Record online: 8 FEB 2010
- Submitted 6 November 2009. Accepted for publication 25 November 2009
- childhood type 1 diabetes;
Ehehalt S, Gauger N, Blumenstock G, Feldhahn L, Scheffner T, Schweizer R, Neu A for the DIARY-Group Baden-Wuerttemberg. Hemoglobin A1c is a reliable criterion for diagnosing type 1 diabetes in childhood and adolescence.
Background: Little is known about the use of the hemoglobin A1C (HbA1c) test for the diagnosis of diabetes in childhood and adolescence. The aim is to investigate sensitivity and specificity of HbA1c at onset of childhood type 1 diabetes.
Methods: A total of 184 children and adolescents with blood glucose levels above 200 mg/dL (11.1 mmol/L) were included: 84.8% (n = 156, mean age 9.0 yr) with new onset of type 1 diabetes, 15.2% (n = 28, mean age 6.1 yr) with transient hyperglycemia. HbA1c was measured using the Bayer® DCA2000 analyzer.
Results: Patients with new onset of type 1 diabetes (n = 156) had HbA1c values between 6.6% and > 14% (mean (SD) 11.4 (2.0)%; IQR, interquartile range 9.8–13.3%). All patients suffered from typical symptoms of hyperglycemia, i.e., polyuria and polydipsia. In the patient group with transient hyperglycemia (n = 28), HbA1c values were between 4.5 and 6.1% (mean (SD) 5.3 (0.4)%; IQR 5.0–5.6%). None of these patients reported typical symptoms of diabetes. All patients with HbA1c values greater than 6.35% had new onset of type 1 diabetes. Sensitivity of HbA1c at the onset of childhood type 1 diabetes was calculated to be 100%. In patients with HbA1c values less than 6.35%, the diagnosis of type 1 diabetes could be excluded. Thus, specificity of HbA1c as diagnostic criterion was 100%.
Conclusions: Childhood type 1 diabetes can be diagnosed and excluded with high reliability by means of HbA1c testing.