Re: A1C the new test for diagnosis of diabetes
- From: Alan S <loralgtweightandcarbs@xxxxxxxxx>
- Date: Tue, 09 Jun 2009 07:39:08 +1000
On Fri, 5 Jun 2009 17:01:36 -0700 (PDT),
kurtwheeling1965@xxxxxxxxxxx wrote:
http://www.diabetes.org/diabetesnewsarticle.jsp?storyId=20243872&filename=20090605/comtex20090605iw00001194KEYWORDMissingEDIT.xmlHere is the original paper; pre-publication:
or
http://tinyurl.com/pwj3dw
(excerpt)
International Expert Committee Recommends New Way to Diagnose Diabetes-
A1C Test Recommended as Tool to Diagnose Diabetes
http://care.diabetesjournals.org/site/misc/DC09-9033.pdf
International Expert Committee Report on the Role of the A1C
Assay in the Diagnosis of Diabetes
It's still only a proposal. I hope that at least one good
thing comes out of it and the push for eAG dies.
The potential for confusion when they use eAG to dumb-down
A1c but they use A1c for diagnosis is frightening.
The crucial recommendations are in table 2:
"Table 2.Recommendation of the International Expert
Committee For the diagnosis of diabetes:
?? The A1C assay is an accurate, precise measure of chronic
glycemic levels and correlates well with the risk of
diabetes complications.
?? The A1C assay has several advantages over laboratory
measures of glucose.
?? Diabetes should be diagnosed when A1C is >=6.5%.
Diagnosis should be confirmed with a repeat A1C test.
Confirmation is not required in symptomatic subjects with
plasma glucose levels >200 mg/dl (>11.1 mmol/l).
?? If A1C testing is not possible, previously recommended
diagnostic methods (e.g., FPG or 2HPG, with confirmation)
are acceptable.
?? A1C testing is indicated in children in whom diabetes is
suspected but the classic symptoms and a casual plasma
glucose >200 mg/dl (>11.1 mmol/l) are not found.
For the identification of those at high risk for diabetes:
?? The risk for diabetes based on levels of glycemia is a
continuum; therefore, there is no lower glycemic threshold
at which risk clearly begins.
?? The categorical clinical states pre-diabetes, IFG, and
IGT fail to capture the continuum of risk and will be phased
out of use as A1C measurements replace glucose measurements.
?? As for the diagnosis of diabetes, the A1C assay has
several advantages over laboratory measures of glucose in
identifying individuals at high risk for developing
diabetes.
?? Those with A1C levels below the threshold for diabetes
but >=6.0% should receive demonstrably effective preventive
interventions. Those with A1C below this range may still
be at risk and, depending on the presence of other diabetes
risk factors, may also benefit from prevention efforts.
?? The A1C level at which population-based prevention
services begin should be based on the nature of the
intervention, the resources available, and the size of the
affected population."
I do not like the implication that it is in lieu of existing
dignosis methods rather than complementary to them, as
implied in "If A1C testing is not possible, previously
recommended diagnostic methods (e.g., FPG or 2HPG, with
confirmation) are acceptable."
Cheers, Alan, T2, Australia.
--
d&e, metformin 2000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Breakfast On The Run)
http://loraltravel.blogspot.com (Jerash, an Ancient City in Jordan)
.
- References:
- A1C the new test for diagnosis of diabetes
- From: kurtwheeling1965
- A1C the new test for diagnosis of diabetes
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