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 Diabetes Center Feature Story

Newer Diabetes Test May Simplify Diagnosis
Measuring A1C levels, done without fasting, could help detect problems earlier

Newer Diabetes Test May Simplify Diagnosis(HealthDay News) -- Although two different fasting blood sugar tests have long been the gold standard in diabetes diagnosis, another test that provides doctors with a two- to three-month snapshot of your blood sugar levels can also be used to diagnose the disease.

Called the glycated hemoglobin A1C, this test may help catch type 2 diabetes and pre-diabetes earlier in the course of the disease.

"We've added another test that can make it easier to find out if you have diabetes," Dr. Richard Bergenstal, president of medicine and science for the American Diabetes Association, told HealthDay.

The group's updated guidelines call for the diagnosis of type 2 diabetes when A1C levels are above 6.5 percent. Pre-diabetes is diagnosed when A1C levels are between 5.7 and 6.4 percent. People without diabetes usually have an A1C of 5 or less.

The biggest benefit of the A1C appears to be convenience. That's because people don't have to fast for eight hours before having their blood drawn to get an accurate result. Bergenstal said that the A1C isn't necessarily superior to the other methods used to detect diabetes and pre-diabetes, but it's somewhat easier.

The test assesses how much of a person's hemoglobin -- a major part of red blood cells -- is glycated, which refers to hemoglobin with an attached blood sugar molecule. Blood sugar molecules attach to hemoglobin when blood sugar levels are elevated. The result is expressed as a percentage, which means that if someone's A1C is 7, then 7 percent of their hemoglobin is glycated.

And, research has shown that the higher the A1C, the greater the risk for serious diabetes complications, such as kidney disease, heart disease and eye problems, according to the U.S. National Library of Medicine.

The A1C test isn't new -- it's been used for years in the management of diabetes -- but it had not been recommended for use in diagnosing diabetes because the test wasn't standardized. A reading of 6.5 percent at one lab, for instance, could have been 6.3 percent at another -- or the difference between type 2 diabetes and pre-diabetes.

Now, however, the test is highly standardized, according to the diabetes association.

Bergenstal did say the association recommends that A1C tests be sent to a lab for results, rather than be tested in the office or at home for an initial diabetes diagnosis.

Experts hope that the new guidelines will lead to earlier diagnosis of diabetes and pre-diabetes because of the ease of testing.

"This is a very practical, innovative concept," Dr. Michael Bergman, an endocrinologist and clinical professor at the NYU Langone Medical Center in New York City, told HealthDay. "People don't need to be fasting for an A1C, and there are fewer variables that can affect the outcome of the A1C."

It's also important progress, Bergman added. "I think diabetes is grossly underdiagnosed, and pre-diabetes even more so," he said. "It's a real problem, and these guidelines may help sensitize the medical community to it."

On the Web

To learn more about the A1C test, visit the American Diabetes Association.

SOURCES: HealthDay News; Richard Bergenstal, M.D., president, medicine and science, American Diabetes Association; Michael Bergman, M.D., endocrinologist and clinical professor, NYU Langone Medical Center, New York City; January 2010, Diabetes Care; U.S. National Library of Medicine (www.medlineplus.gov)

Author: Serena Gordon

Publication Date: Jan. 31, 2011


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