From Buffalo, New York, USA:
How should children with pre-diabetes be managed? Is it appropriate to have them check blood sugars when they haven't been diagnosed with type 2 yet? Do any doctors follow the ADA and American Academy of Pediatrics recommendations to do a fasting sugar in high risk children (repeat every two years) instead of just drawing up an A1c on every overweight child?
The intervention for pre-diabetes is to enter the child and family in a lifestyle program addressing nutrition and physical activity. There are a number of programs in your area. In fact, you have the guru there - Dr. Len Epstein, Professor of Pediatrics and Behavioral Medicine at the University at Buffalo. Fasting glucose is the method of screening. A1c values are not used for screening. Of course, if you think a child has developed diabetes, then a random glucose can be obtained as well. And, then, the A1c is done for confirmation. However, the diagnosis of diabetes is made on blood glucose values only.
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