Type 2 Diabetes Guidelines Changes Lead to Concerns

According to a recent study conducted by the University of Michigan, new guidelines released by the American Diabetes Association for screening patients may result in missed diagnoses of Type 2 Diabetes in children. The concern is particularly strong as cases of Type 2 Diabetes continue to rise in alarming rates—particularly among young children; in addition, early intervention and treatment of the disease has demonstrated benefits to patients who may be able to partially reverse their condition over the course of a lifetime. If the disease is not caught early, secondary health issues, such as nerve damage, vision loss, and heart disease can easily occur.


Diabetes Guidelines are Already Steeped in Controversy


The research, which was published in the Journal of Adolescent Health, found that both pediatric and family medicine providers are using screening tests which may resulted in missed diagnoses of Type 2 Diabetes in children, according to lead author Joyce Lee, M.D., M.P.H., and associate professor at U-M’s Departments of Pediatrics and Communicable Diseases and Environmental Health Sciences. Patients who develop Type 2 Diabetes require strict glucose monitoring using blood-glucose meters such as the Prodigy auto code, and many of them require medication in addition to changes to lifestyle and diet. In 2010, the ADA recommended that physicians use the Hemoglobin A1c screening test, rather than glucose tests, for identifying children and adults with pre-diabetes and diabetes. The change was controversial due to lower performance of the HbA1C test in children compared to adults.


While the controversy persists, the study found that when presented with the ADA guidelines, 84% of physicians stated that they would switch from using glucose tests to HbA1c tests; Lee says of the finding, “This potential for increased uptake of HbA1c could lead to missed cases of prediabetes and diabetes in children, and increased costs.” According to Lee and many other critics of the ADA guidelines, several studies have shown that not only is the A1c test less effective for pediatric patients in comparison to adults, but also that the test is less cost-effective than other screening tests, which leads to higher overall costs for screening. At a time when Type 2 Diabetes is rapidly becoming the most important public health initiative worldwide—with doctors all over the globe concerned about the growing increase  in rates of incidence—the possibility of missing cases is a very large concern in the medical community. Researchers theorize that many with Type 2 Diabetes are unaware that they have the condition until relatively routine blood work shows the disease has developed; the early symptoms of Diabetes are relatively easy for people to miss in themselves.


Why are Diabetes Doctors Concerned?


Dr. Lee, among other medical professionals and researchers, is primarily concerned with the fact that the possibility of decreased detection can lead to poorer long-term outcomes. For those with a family history of diabetes, it is definitely important to be educated on the issue, and to ensure that you are asking questions—both for yourself and your children. Type 2 Diabetes treatment can seem daunting, particularly with the need for tools such as the Prodigy auto code meter, which requires multiple blood samples per day; however, treatment for the lifelong disease is vital for health and wellness. Diabetes treatment helps many people live longer lives.


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