HbA1c and the Prediction of Type 2 Diabetes in Children and Adults
Open accessAbstract
OBJECTIVE: Long-term data validating glycated hemoglobin (HbA1c) in assessing the risk of type 2 diabetes in children are limited. HbA1c, fasting plasma glucose (FPG), and 2-h postload plasma glucose (2hPG) concentrations were measured in a longitudinal study of American Indians to determine their utility in predicting incident diabetes, all of which is thought to be type 2 in this population. RESEARCH DESIGN AND METHODS: Incident diabetes (FPG ≥126 mg/dL [7.0 mmol/L], 2hPG ≥200 mg/dL [11.1 mmol/L], HbA1c ≥6.5% [8 mmol/mol], or clinical diagnosis) was determined in 2,095 children without diabetes ages 10–19 years monitored through age 39, and in 2,005 adults ages 20–39 monitored through age 59. Areas under the receiver operating characteristic (ROC) curve for HbA1c, FPG, and 2hPG in predicting diabetes within 10 years were compared. RESULTS: During long-term follow-up of children and adolescents who did not initially have diabetes, the incidence rate of subsequent diabetes was fourfold (in boys) as high and more than sevenfold (in girls) as high in those with HbA1c ≥5.7% as in those with HbA1c ≤5.3%—greater rate ratios than experienced by adults in the same HbA1c categories. Analyses of ROCs revealed no significant differences between HbA1c, FPG, and 2hPG in sensitivity and specificity for identifying children and adolescents who later developed diabetes. CONCLUSIONS: HbA1c is a useful predictor of diabetes risk in children and can be used to identify prediabetes in children with other type 2 diabetes risk factors with the same predictive value as FPG and 2hPG.
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HbA1c is included in the American Diabetes Association diagnostic criteria for diabetes.
“HbA1c is included in the American Diabetes Association diagnostic criteria for diabetes (5, 6)”
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Cites
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Hampl, S. E., Hassink, S. G., Skinner, A. C., Armstrong, S. C., Barlow, S. E., Bolling, C. F., Avila Edwards, K. C., Eneli, I., Hamre, R., Joseph, M. M., et al. (2023) · Pediatrics · doi:10.1542/peds.2022-060640 · Cited by 1,389 · see citing works
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Xue, H., Zhang, L., Shi, Y., Zhang, H., Zhang, C., Liu, Y., Tan, W., & Liu, Y. (2025) · Frontiers in Digital Health · doi:10.3389/fdgth.2025.1630588 · Cited by 15 · see citing works
- Authors
- Vijayakumar, P., Nelson, R. G., Hanson, R. L., Knowler, W. C., & Sinha, M.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Sinha, Madhumita
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2016-11-03
- Volume
- 40
- Issue
- 1
- Pages
- 16-21
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC5180461
- OpenAlex
- W2548368175
- Cited by
- 93
- References
- 1
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 10 · 2023: 13 · 2022: 5 · 2021: 11 · 2020: 11 · 2019: 7 · 2018: 16 · 2017: 5
- FWCI
- 9.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- HbA1c, type 2 diabetes, diabetes risk prediction, prediabetes, fasting blood glucose, children and adolescents, Native Americans, diabetes incidence, sensitivity and specificity
- MeSH terms
- Adolescent, Adult, Blood Glucose, Child, Diabetes Mellitus, Type 2, Fasting, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Indians, North American, Longitudinal Studies, Male, Middle Aged, Prediabetic State, Predictive Value of Tests, Risk Factors, ROC Curve, Sensitivity and Specificity, Incidence, Young Adult
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