Prevention Is Better Than Cure: Early Diagnosis Of Risk Term Paper

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¶ … medical sciences, prevention is emphasized as the most desirable response to potential health issues. This has important implications for the way in which patients receive health care in hospitals and other health care settings. This is especially the case where new diagnostic tools have been researched to determine the likelihood of contracting conditions like diabetes. Populations such as young children can particularly benefit from this, since preventative action taken early in life becomes a lifestyle habit that influences the health for the duration of the person's life. Nowicka et al.'s (2011) article, "Utility of Hemoglobin A1c for Diagnosign Prediabetes and Diabetes in Obese Children and Adolescents," provides information about this diagnostic tool, which can then be used to help parents and children determine lifestyle changes to minimize the chances of contracting the condition. The article's objective is to focus on Hemoglobin A1c (A1C) as a diagnostic tool for diabetes and the likelihood for future diabetes in young children. The authors point out that data from previous studies have shown a positive correlation between A1C and the development of diabetes and microvascular complications in adulthood. Studies have not been conducted extensively on children, which prompted the work in question.

In terms of research design and methods, the authors focused their efforts on obse children and adolescents without a diabetes diagnosis. A multiethnic population of 1,156 participants were included...

...

Tests they underwent included an oral glucose tolerance test (OGTT) and A1C measurement. After a follow-up time of 2 years, the test was repeated for 218 subjects.
The results showed that 77% of the population presented normal glucose tolerance, while 21% proved to be at risk for diabetes, and 1% had the condition. For those in the at-risk group, 47% were diagnosed with prediabetes or diabetes. In the diabetes gropu, 62% were classified with type 2 diabetes by OGTT. Where the tests were repeated, the strongest predictors of 2-H gucose were baseline A1C and 2-h glucose. These results are independent of age, ethnicity, sex, fasting glucose, or follow-up time.

The conclusions indicate that, because an A1C of 6.5% is not a true indication of the level of prediabetes and diabetes in obese children and adolescents, it is not a very good diagnostic tool for the condition. According to the American Diabetes Association, there is low sensitivey and specificity, so hemoglobin by itself does not prove to be a good indicator of the condition.

The reasons for conducting the study include the fact that numerous studies have shown a strong correlation between A1C and the development of diabetes and some of its comorbitities. Furthermore, there is no requirement for a fasting state, A1C shows 3-4 monghts before glycemia and has low variability among individuals. According to studies examined by the authors, it also has a good correlation with complications…

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References

Ali, M.K., Echouffo-Tcheugui, J.B., and Williamson, D.F. (2012, Jan.) How Effective were Lifestyle Interventions in Real-World Settings that were modeled on the Diabetes Prevention Program? Health Affairs, 31(1). Retrieved from: http://content.healthaffairs.org/content/31/1/67.full.html

The Diabetes Prevention Program Research Group. (2013, Apr.). The 10-Year Cost-Effectiveness of Lifestyle Intervention or Metformin for Diabetes Prevention: An intent-to-treat analysis of the DPP/DPPOS. Diabetes Care, 35(4). Retrieved from: http://care.diabetesjournals.org/content/35/4/723.full.pdf+html%20

Nowicka, P., Santoro, N., Liu, H., Lartau, D., Shaw, M.M., Goldberg, R., Gundalini, C., Savoye, M., Rose, P., and Caprio, S. (2011, June). Utility of Hemoglobin A1c for Diagnosign Prediabetes and Diabetes in Obese Children and Adolescents. Diabetes Care, 34(6). Retrieved from: http://care.diabetesjournals.org/content/34/6/1306.full


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