accurate reading

More precise blood test could help prevent serious diabetes complications

by Barbara Hewitt on March 24, 2016

A new, more precise blood test to help people with diabetes monitor their blood sugar levels is now being used in the United States.

The improved version of the more common A1C test allows people with diabetes to more accurately track how well they’ve controlled their blood sugar over months.

According to healthcare experts at the University of Virginia it is helping prevent potentially serious complications such as nerve pain and kidney disease.

diabetes-insulin-blood test

The test can also diagnose diabetes, identify people at risk for diabetes and detect blood abnormalities such as sickle-cell disease.

“Diabetes is very prevalent in the US. It has a huge impact on the economy and on healthcare, and it is a chronic condition that creates burdens for those who have it,” said David Bruns, managing director of the university’s Department of Pathology, who, with Lindsay Bazydlo and Doris Haverstick oversees the testing in the UVA Medical Laboratories.

The A1C test is a way of knowing levels of a blood sugar called glucose that were present over the three to four months before the blood sample was collected. A1C is formed as glucose binds to haemoglobin molecules in red blood cells during their lifespan of four months in the body.

More A1C is formed when the patient’s glucose is high, and less is formed while glucose is low. Results of the A1C test are reported as a percentage of the haemoglobin that has sugar attached to a specific part of the haemoglobin. There are multiple forms of haemoglobin, but up to 98% is usually of the form A, contributing to the name of the test, A1C.

Carefully determined cut-off values for A1C define whether a person has diabetes or is at risk for diabetes. People are diagnosed with diabetes when more than 6.5% of their haemoglobin is bound to sugar, and they are at risk for diabetes when that figure reaches 5.7%.

The use of these fixed cut-off values requires a very accurate method of measuring A1C because small errors could lead to a misdiagnosis. “What sound like small differences in percentage of A1C in the blood are very significant in predicting health outcomes of patients,” Bazydlo said.

Bruns explained that the test now has multiple uses. “In the past, the A1C test was used solely for monitoring blood sugar levels, allowing for better adjustment of medication. Now, physicians also use the test to diagnose diabetes without the need for a fasting sample or drinking a glucose solution for a glucose tolerance test,” he added.

The new test uses a more accurate technique, known as capillary electrophoresis, which simultaneously allows measurement of haemoglobin A1C and detection of abnormal inherited haemoglobins that may be present.

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