Insulin is a hormone produced by the body in order to convert sugar, starches and other foods into energy. Insulin “opens” the body’s cells so that glucose (blood sugar) can enter and fuel them. When insulin is not produced by the body, the patient is said to be suffering from Type 1 diabetes. When insulin is produced but not properly utilized, the patient is said to be insulin resistant and suffering from Type 2 diabetes. Two other conditions complete the disease spectrum: Gestational diabetes, which afflicts some women immediately after childbirth, and Pre-diabetes, a condition occurring when blood glucose levels are higher than normal but not high enough to be diagnosed as Type 2 diabetes.
Undiagnosed and/or uncontrolled diabetes can have serious, sometimes life-threatening consequences. Diabetes is an insidious and damaging disease, which slowly attacks the eyes, organs, and extremities. Continuous monitoring is crucial to controlling its adverse effects.
The list of conditions associated with diabetes is extensive:
- Stroke & Heart Disease
- Kidney Disease
- High Blood Pressure
- Periodontal Disease
- Kidney Disease
- Sexual Dysfunction
- Pregnancy Complications
The exact causes of diabetes remain unknown, but both genetics and environmental factors play a role, especially lack of exercise and obesity. Identification and monitoring of the disease are accomplished through the use of blood testing.
The standard methods used to determine a patient’s risk level for diabetes have always been the fasting blood glucose (FBG) test or, in some cases, the oral glucose tolerance test (OGTT). Once diagnosed, ongoing monitoring of the disease is done through the use of a hemoglobin A1c (HbA1c) test. The HbA1c test measures a diabetes patient's total glycated hemoglobin and accurately measures the average blood glucose (blood sugar) level over the previous 60 to 90 days.
Blood sugar binds irreversibly to hemoglobin to form what is called a glycated hemoglobin complex. This complex is very stable and can be analyzed at predetermined intervals (usually 90 days) to determine the patient's overall blood sugar control. This is important because even though a patient may correctly measure his or her daily blood sugar levels, those levels will fluctuate considerably based on immediate circumstances. The HbA1c test, however, deals only with the average blood sugar level over the previous two to three months, making it a much more accurate and meaningful diagnostic tool.
An HbA1c number above 7.0% is considered poor blood sugar control, while 6.0% or lower is the ideal and usually considered the goal for most diabetics. A number between 6.0% and 7.0% usually signifies a pre-diabetic condition.
Although the FBC and OGTT tests have been used for years to identify diabetes, and they are accurate at measuring real-time glucose levels, their results can easily be compromised if the patient has a cold or hasn’t eaten properly before taking the test. This makes the process unnecessarily inconvenient for both patient and clinician. But that is about to change.
A recent article in the Journal of Clinical Endocrinology and Metabolism strongly suggests that HbA1c, in addition to monitoring the disease, should also be used to screen for it. With over six million people at risk, an easier and more efficient method must be found to identify them and the authors suggest the HbA1c test as the tool to do this.
Three factors support their recommendation: HbA1c does not require patients to fast; HbA1c laboratory methods are now well standardized and reliable; and errors caused by non-glycemic factors affecting HbA1c are uncommon and can be minimized by confirming the diagnosis of diabetes with a plasma glucose-specific test.
The Diabetes Control and Complications Trial (DCCT) has shown that the lower the A1c number, the better are the patient's chances of slowing or even preventing serious damage to the eyes, nerves, and kidneys. Any improvement in A1c levels has the potential to reduce complications.
Geonostics has made the process of collecting blood samples in specialty situations easier than ever. Through the use of customized collection kits, a four drop micro-sample specimen can be collected by health care professionals or directly through patients’ self-collection. Providers, as well as patients, appreciate the ease and convenience of finger stick collection, and with multiple transportation options, samples can be shipped to our lab from almost anywhere in the world.
HbA1c screening can now play an important role in early diabetes detection as well as ongoing disease monitoring. Increased awareness and ease of access to screening are key. The importance of HbA1c testing for diabetes cannot be overemphasized and Geonostics has dramatically simplified the process.