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Experts Urge One Test to Diagnose Diabetes
Date:6/5/2009

elines will also appear in the July issue of Diabetes Care.

Currently, two tests are widely used to diagnose type 2 diabetes, which now afflicts some 24 million Americans: fasting plasma glucose or oral glucose tolerance tests. Both look at short-term blood glucose levels and involve some inconvenience to patients, including fasting for periods of time before blood is drawn.

Blood glucose levels are also notoriously fickle, changing depending on how recently the patient exercised or ate a meal or snack. Blood sugar can also fluctuate if a person has a cold or if the blood sample is kept at room temperature or in a colder environment.

So, "the results are sometimes difficult to interpret," Nathan said. "With A1C, it doesn't really matter. We consider this a preferred method of diagnosing diabetes. It doesn't care what blood glucose levels are after dinner, before dinner, if you have a cold. It integrates all those levels."

The committee based its recommendations on a review of the literature, focusing on what A1C levels were more likely to result in diabetic retinopathy, a vision-threatening eye condition that is one potential complication of the disease.

"Diabetes is associated with both elevated levels of blood sugar and a host of complications and the one we can measure most quantitatively is retinopathy," Nathan explained. "Glucose levels span an enormous distribution. There's no clear-cut point. To pick a dividing line, we looked at glucose levels associated with this complication."

"After reviewing lots of clinical chemistry data, we determined that there are numerous advantages of A1C," he continued.

People with A1C levels between 6 and 6.5 percent are considered to be at higher risk for diabetes, the committee said.

Experts speaking at the teleconference emphasized that the conventional blood glucose tests are not to be discarded, especially in areas of the world where A1C
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