Frequency and results of glucose screening in children and adolescents 2007-2011 [poster]
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Background: The aim of the study was to ascertain frequency of glucose screening in children and adolescents, in predefined age, gender, BMI, and race strata. Methods: Study subjects included 68,322 individuals age 3-17 years at cohort entry and followed for a median of 37 months. Subjects had at least one office visit at HealthPartners Medical Group (HPMG). Subjects had their laboratory data examined for date and results of any fasting or random glucose, glycated hemoglobin (A1c), or oral glucose tolerance tests done in an outpatient setting. We report descriptive statistics on rate of glucose testing and rate of tests indicating pre-diabetes by age, gender, BMI, race/ethnicity group, and calendar year. Results: Overall rate of glucose screening was 10.7% (7278/68322). Rates increased in recent years compared to earlier years, were similar in males and females, and were greater in older subjects, those with obesity, and those of minority race or Hispanic ethnicity. The test rate was 4.4% (1145/26245) per year in 2007 compared to 19.7% (1687/8563) in 2010. Glucose screening was most often done with fasting or random glucose, but 7.7% (560/7278) of tests were glycated hemoglobin (A1c). About 13.9% (1013/7278) of tests showed results indicating pre-diabetes. Of the 1013 with a test result indicating pre-diabetes, 79.1% (801/1013) were age 12 and older, 60% (608/1013) were of minority race or Hispanic ethnicity, and 30.9% (313/1013) were obese. Diabetes diagnosis (250.xx) was present in 2.2% (161/7278) of the subjects with one or more glucose/A1c tests. Conclusions: Rates of glucose testing are highest in demographic subgroups with the highest risk, and have increased markedly in recent years. As the rate of screening increases further, it is likely that the proportion that screen positive for pre-diabetes or diabetes will decline. A substantial number of adolescents have recently been identified as having pre-diabetes, and further work is needed to characterize care subsequently provided to these subjects, and to characterize other CV risk factors.