Development of an Assessment Tool for Screening Children for Glucose Intolerance by Oral Glucose Tolerance Test
- Sarah Ehtisham, MBBCHIR,
- Nick Shaw, MBCHB,
- Jeremy Kirk, MD and
- Timothy Barrett, PHD
- From the Department of Diabetes and Endocrinology, Birmingham Children’s Hospital, Birmingham, U.K.
- Address correspondence to Dr. Sarah Ehtisham, Diabetes Homecare Unit, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, U.K. E-mail: s.ehtisham{at}bham.ac.uk
The American Diabetes Association (ADA) has recommended screening for type 2 diabetes by fasting plasma glucose (FPG) in children who are overweight (BMI >85th percentile) who have two of the following risk factors: at-risk ethnic minority origin, family history of diabetes in a first- or second-degree relative, or insulin resistance (acanthosis nigricans, polycystic ovarian syndrome, hypertension, or dyslipidemia) (1).
The case for refining the criteria for screening has been made previously (2). In that study, the sensitivity of the criteria was 24%, with a positive predictive value of 3%, i.e., 40 children needed to be tested to yield one abnormal result. In a response to this, Rosenbloom (3) highlighted the need to test the ADA criteria in high-risk populations to establish the strength and risk level of different …
