Old Test, New Application in Diabetes Detection
The "old dog" that is hemoglobin A1c (HbA1c)-the gold standard for diabetes monitoring-apparently has learned a new trick. According to research released by Johns Hopkins (www.hopkinshospital.org/diabetes) today, the test-primarily used to monitor patients that have been diagnosed with diabetes-may have a broader application in identifying millions of people with undetected diabetes.
"The test is a measure of long-term glucose control, but doctors don't typically use it to screen for or diagnose the disease," says Christopher Saudek, MD, professor of endocrinology and metabolism at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Comprehensive Diabetes Center. "There's reason to believe it could help identify many of the estimated six million people in the U.S. who have diabetes but don't know it," he adds.
One of the benefits of using the HbA1c test as a frontline method of detection is that it doesn't require fasting and, thus, is not affected by short-term changes in diet. Many patients tend to make all the right adjustments to their diet just before going in for diabetes testing-similar to the way one tends to spend an extraordinarily long amount of time brushing his teeth the morning of a dentist appointment. Using HbA1c could eliminate the possibility of skewed results. A national panel of diabetologists, pathologists and internists has put forth recommendations regarding the results of the HbA1c test.
...Individuals who score at least 6 percent on an HbA1c test may have or be at risk for diabetes and should be tracked with additional glucose or HbA1c tests. Those who score between 6.5 percent or above, if confirmed, should be considered to have diabetes. "This is a first step towards changing medical practice," notes Saudek, and "could greatly enhance how well we're able to identify people with diabetes."