Which laboratory test is most appropriate to assess long-term glycemic control in a pediatric patient with diabetes?

• A. Glycosylated hemoglobin
• B. Serum glucose
• C. Lipid panel
• D. Urine glucose

Answer: (A)

Long-term glycemic control is best assessed with glycosylated hemoglobin because it reflects the average blood glucose over the lifespan of red blood cells (about two to three months). This provides a picture of how well diabetes has been managed over time, rather than just a single moment’s level. A serum glucose test shows glucose at one point in time and can vary a lot, so it doesn’t capture overall control. Urine glucose indicates glucose spilling into urine at that moment and isn’t a measure of long-term control. A lipid panel serves to evaluate cardiovascular risk and lipid status, not glucose control. So the glycosylated hemoglobin test is the most appropriate choice for monitoring long-term glycemic control.