Blood test detects risk of type 2 diabetes much earlier

by Barbara Hewitt on January 31, 2014

A simple blood test currently used to diagnose diabetes can show if someone is at risk of developing type 2 diabetes far earlier than previously thought, new research has found.

The discovery could help doctors provide an earlier diagnosis for prediabetes, a condition that often goes on to develop into diabetes, and provide appropriate help and advice such as lifestyle changes.

blood test diabetes

The American Diabetes Association and World Health Organization have added the A1c test to their guidelines as a criterion for diagnosing type 2 diabetes

A team at the Sackler Faculty of Medicine at Tel Aviv University in Israel, led by Dr Nataly Lerner, found that the A1c test, used to diagnose type 2 diabetes, can also be used at a much earlier stage to screen for the disease in the high risk population, like overweight patients.

Blood glucose can be directly tested in several ways, but these tests only provide a snapshot. To get a picture of blood glucose levels over time, doctors test for levels of glycated haemoglobin, or A1c, in the blood. When blood glucose levels are high, more A1c is formed. So A1c serves as a biomarker, indicating average blood glucose levels over a two to three month period.

The A1c test has long been used to monitor type 2 diabetes. And in the past few years, the American Diabetes Association and World Health Organization have added the test to their guidelines as a criterion for diagnosing type 2 diabetes.

According to the ADA, having an A1c level of 6.5% or more is an indicator of the disease and an A1c level of between 5.7 and 6.4 percent is an indicator of prediabetes. As a bonus, the test is simpler to administer than the most common blood glucose tests, requiring neither fasting nor eating anything.

To evaluate the A1c test’s ability to screen for diabetes in high risk patients, the researchers analysed the medical history of 10,201 patients who were given the test in central Israel between 2002 and 2005.

They found that overall, 22.5% of the patients developed diabetes within five to eight years. Patients with A1c levels as low as 5.5%, actually below the official threshold for diagnosing diabetes, were significantly more likely to develop diabetes than patients with A1c levels below 5.5%.

Every 0.5% increase in A1c levels up to 7% doubled the patients’ risk of developing diabetes. Obesity also doubled patients’ risk of developing diabetes, the researchers found.

‘We were actually able to quantify how risk increases with A1c levels. This could allow doctors to make more informed decisions regarding diabetes prevention,’ said Dr Lerner.

She pointed out that the study is one of the most comprehensive of its kind, and compelling new evidence that the A1c test can accurately gauge risk at an earlier stage than is currently recognised.

In combination with blood glucose tests and the identification of risk factors like family history, poor diet, lack of exercise, and obesity, the test could help doctors provide earlier treatment. In some cases, lifestyle changes or medication could head off the disease.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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