Limitations
metabolic disease, diabetes
METABOLIC DISEASE, DIABETES
There are several other limitations to mention. The first limitation is that multiple imputations could not be run on the missing data of the survey data with the blood variables, because too many variables were included to make the analysis congenial and the imputation models would not converge with the blood variables, so complete case analyses was run. The subsample of children who participated in the optional blood draw had higher BMI, BMI percentiles, and overweight and obesity prevalence compared with children who did not participate in the blood draw. One explanation for this is that parents of heavier children may have been more concerned about their child’s health and opted to receive the free diabetes screening, which is how we marketed this to the families. In addition, the individuals in the subsample with blood draws were more likely to be Hispanic and less likely to be White, and Hispanic individuals in this population may have less access to health care, which could have encouraged them to sign up for the free diabetes screening test. Regardless, it appears that the subsample with blood draws represented a higher risk group; thus, the results cannot be generalized to healthier pediatric populations. However, these results highlight that this intervention could be effective at reducing metabolic disease risk in a high-risk subset of children. Another limitation is that the HbA