Course of HbA1c in prediabetic conditions in pediatric endocrine practice
International Journal of Diabetes in Developing Countries, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s13410-026-01632-z
- Dergi Adı: International Journal of Diabetes in Developing Countries
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Children, HbA1c, Obese, Overweight, Prediabetes
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: According to the ADA guideline, children with HbA1c between 5.7% and 6.4% are classified as “prediabetes”; however, the applicability of adult cut-offs to pediatric populations remains controversial due to pubertal physiology and ethnic variation. Objective: We evaluated the clinical trajectory of children with HbA1c in the prediabetes range, focusing on the natural course, determinants of normalization, and the utility of repeated HbA1c measurements. Methods: A total of 1817 children whose HbA1c was measured at our center between 2021 and 2023 were retrospectively examined. Individuals with type 1 diabetes mellitus (DM), type 2 DM, and MODY and those with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) on oral glucose tolerance test (OGTT) were excluded. This study is defined as a retrospective cohort study, reflecting the temporal follow up of HbA1c levels. Results: A total of 302 children had a first HbA1c in the prediabetes range and normalized (< 5.7%) within 1 year. The median HbA1c normalization time was 8 months (range 2–12 months). Kaplan–Meier analysis showed significantly delayed normalization in children with baseline HbA1c ≥ 6.0% compared with those between 5.7–6.0% (log-rank p < 0.001). Cox regression demonstrated that baseline HbA1c ≥ 6.0% independently predicted slower normalization (HR: 0.62; 95% CI: 0.48–0.81). Puberty, age, sex, and BMI SDS were not significant predictors. Conclusions: A single elevated HbA1c should not automatically lead to a prediabetes diagnosis. Physiological pubertal insulin resistance and ethnic factors may temporarily elevate HbA1c. Repeated HbA1c testing appears clinically valuable and may prevent unnecessary OGTT testing or pharmacologic interventions.