In addition, while HbA1c reflects the long-term plasma glucose, 1,5-AG and GA are indices reflecting the short- or intermediate-term plasma glucose. 1,5-AG and glycated albumin (GA) are indices that overcome these weaknesses of HbA1c: they offer the benefits of reflecting glycemic control in patients with hematological disorders and also reflecting the postprandial plasma glucose. Therefore, it is thought that HbA1c is less sensitive to diabetic macroangiopathy than diabetic microangiopathy. On the other hand, the following problems have been pointed out: since HbA1c shows an abnormal value in the case of hemolytic anemia or variant hemoglobin, it does not reflect glycemic control, and HbA1c mainly reflects mean plasma glucose and does not so much reflect postprandial plasma glucose and/or fluctuation of plasma glucose. However, due to several reasons including the fact that the chronic hyperglycemic state is rather reflected by HbA1c than by plasma glucose, that fasting plasma sampling and loading tests are unnecessary, and that it is possible to follow the state using the same index after treatment, the American Diabetes Association introduced HbA1c for the diagnosis of diabetes mellitus in 2009. To date, diabetes mellitus has been diagnosed by using fasting plasma glucose, randomly measured plasma glucose, or plasma glucose after loading in the oral glucose tolerance test. Thus, it is possible to inhibit such onset and development by achieving good glycemic control. Prospective Diabetes Study (UKPDS), and the Kumamoto study have shown that the onset and development of diabetic microvascular complications are correlated with HbA1c. Furthermore, large-scale studies such as the Diabetes Control and Complications Trial (DCCT), U.K. By using HbA1c as the index, it is possible to select a method for treating diabetes mellitus and to evaluate its appropriateness. Thus, HbA1c began to be used as an index of glycemic control reflecting the long-term glycemic control. Once HbA1c is formed, it remains in the body until red blood cells are destroyed. Glycated hemoglobin (HbA1c) is a nonenzymatic glycation product of hemoglobin. However, these indices change from moment to moment due to factors such as dietary intake, and it is difficult to judge glycemic control accurately by measurement at one point. In the past, glycemic control was judged by plasma glucose or urinary glucose. Masafumi Koga, in Advances in Clinical Chemistry, 2014 1 Introduction Among the subgroup of Navajo adolescents aged 15–19, 1 in 359 had diabetes, with a prevalence of 2., and 1 in 2542 developed diabetes annually. The highest prevalence of T2D was in American Indian youth, with 76% of diabetics classified as T2D, a prevalence of 1.74 cases per 1000 youth. In African American diabetic youth, 33% had T2D with a prevalence of T2D of 1.06/1000. In Asian and Pacific Islander diabetic youth, 40% had T2D with a prevalence of T2D of 0.52/1000. T2D exceeded T1D in Hispanic female adolescents aged 15–19 years. In Hispanic American diabetic youth, 22% had T2D with a prevalence of 0.48/1000. In non-Hispanic whites, 6% of diabetics had T2D for a prevalence of 0.18 cases per 1000. In the 10- to 19-year-old age group, the proportion of diabetics with T2D varied by ethnicity. More than 6000 youth 80% of diabetic children and adolescents were classified as T1D regardless of ethnicity. The SEARCH for Diabetes in Youth study involved six centers in the United States of youth with physician-diagnosed diabetes. Interestingly, the frequency of T2D diagnosed by this screening program has not changed significantly since 1974 and was actually lowest in the most recent screening period of 2001–04. In junior high students the rate increases to 6.27/100,000/year. The overall incidence of T2D is estimated to be 2.55/100,000/year during 1975–2000. Through this program, 236 children, of which 189 were junior high school students, have been diagnosed with T2D. Glycosuria on first screening is reported in 0.05%–0.1% of primary school children and 0.12%–0.2% of junior high school children. ![]() Almost 10 million children have been screened. Japan has been conducting urine glucose screening in school children since 1975. ![]() Kathryn Love-Osborne, in Global Perspectives on Childhood Obesity (Second Edition), 2019 4.2 Global T2D Prevalence Reports
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