ADA: Change the way to diagnose diabetes

Change the way to diagnose diabetes
An expert committee from several countries recommends a new test for the diagnosis of diabetes.

The American Diabetes Association (ADA), the International Diabetes Federation (IDF) and the European Association for the Study of Diabetes (EASD) are inclined to a new diagnostic test to determine if a patient is diabetic.The A1C analysis, which already has the guarantee of the expert committee designated by the three organizations, has been the protagonist of one of the sessions of the Annual Congress of the ADA, which is held these days in New Orleans (United States).

The A1C hemoglobin test is a blood test that allows blood glucose control to be measured over a period of about three months.When the blood sugar level is high, sugar adheres to hemoglobin protein in red blood cells, forming hemoglobin A1C.Since red blood cells live from 90 to 120 days, hemoglobin A1C remains in the blood between 90 and 120 days.That is why the amount of hemoglobin A1C in the blood is a way to measure what the blood sugar level has been during the last 3 months.

The report of the Committee, which has been announced in the advanced edition of the 'Diabetes Care' magazine on the Internet, can be a huge change in the way of diagnosing the disease.As of today, two other tests are used: fasting glucose (FPG) and oral glucose tolerance test (OGTT).

To reach its conclusions, the expert committee analyzed the relationship between long -term glucose levels and patient health complications, from which it suggested that a reliable measure of those levels (such as the A1C hemoglobin test) It can be better diabetes indicator and should be the reference diagnostic tool.

From Aguedoc on David M. Nathan, director of the Diabetes Center of the General Hospital of Massachusetts, "A1C values ​​vary less than those of FPG, and the first test has technical advantages regarding the second."In addition, -Añade- "The diagnosis of diabetes with A1C is more convenient and easy for patients, since it does not require the test on an empty stomach or the oral glucose tolerance test."

In the data review on the relationship between A1C levels and long -term diabetes complications, such as retinopathy (damage to the blood vessels of the retina, which can trigger blindness), the committee came to the conclusion ofthat A1C levels above 6.5 percent are useful for diagnosing the disease.This cutting threshold, Dr. Nathan clarifies, should not be considered a strict measure but rather orientative.

For the identification of people whose risk of developing diabetes is very high, the committee concludes that A1C levels above 6 percent is a good indicator, although they are precaution to insist that this point is not defining in all cases.

"Glucose alteration occurs in the form of a continuous process, so that establishing a specific value from which the risk of diabetes is triggered is arbitrary. However, in those people in which the level exceeds 6.5percent, or is close to him, the risk is certainly greater, "he added.

The American Diabetes Association recommends screening tests with all adults with overweight and additional risk factors, such as family history of diabetes, hypertension or abnormal levels of blood lipids.Adults who do not have any of these factors should begin to perform tests from 45 years.

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On the one hand I see it well, in a predebut or prediabetes process, there are few variations of blood glucose, it is always high:-/ there are no those changes of 50 and 300 mg/ dl ... so the final result of glycosiladaIt is reliable.

On the other hand, I think they should make a wide battery of tests (antibodies, C peptide, curves ...) The cases of infradiagnostic Modly would be reduced, I suppose.

Until recently the calculation of glycosilada was not homogenized in all centers and I fear that it still does not really be ...

On the other hand, initial stages of type 2 must be little sensitive to glycosilada, right?

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