Prevention Is Better Than Cure: Early Diagnosis of Risk

¶ … 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 in the study, of whom 40% were male and 60% female. 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 related to diabetes. These factors were drawn only from studies conducted on adults and were therefore determined as a useful guideline for applying the study to children as well. The fact that hemoglobin did not prove to be a very good indicator of the condition is important for the diagnosis and prevention of diabetes, since it is now know that different diagnostic tools will be needed for children.

Effectively determining the level of risk young children are exposed to for diabetes is important, especially in terms of prevention. Indeed, it is easier to cultivate certain eating and exercising habits in children who have been diagnosed with prediabetes than it is in adults who have had the condition for years. Children are young and generally adjust more easily than adults to various requirements for change. A further advantage for children is that they have their parents to help control their habits as concerns food and exercise. When the parents of such children are committed to the health of the entire family, such children receive the benefit of a controlled environment and healthy habit cultivation. Parents can also enlist the help of programs such as the Diabetes Prevention Program (Ali, Echouffo-Tcheugui, and Williamson, 2012).

According to Nowicka et al. (2011), early diagnosis of risk can help young individuals enroll in programs such as the above-mentioned in order to cultivate a healthy lifestyle. This will lead to long-term prevention.

Ali, Echouffo-Tcheugui, and Williamson (2012) have found that the program is useful in terms of helping individuals lose weight by a combination of healthier food choices and exercise. The Diabetes Prevention Program Research Group reiterates that lifestyle choices are the best and most likely effective solution for preventing the condition in young children. This intervention is also cost-effective, since no expensive or chronic medication is necessary.