December 2023—The third and latest edition of recommendations for laboratory analysis in diagnosing and managing diabetes mellitus, released this summer, provide guidance on, among other things, ketone testing, glycolysis, and point-of-care testing. The last such recommendations were published in 2011.
Read More »In some settings, alternatives to HbA1c acceptable
November 2023—Glycated albumin and fructosamine are highly specific, with high levels suggesting hyperglycemia. This points to their utility in monitoring glycemic control in people with diabetes. “They’re quite useful in the setting of overt hyperglycemia,” said Elizabeth Selvin, PhD, MPH, at this year’s meeting of the Association for Diagnostics and Laboratory Medicine.
Read More »Lab analysis in diabetes — a preview of what’s to come
November 2021—The guidelines for laboratory analysis in the diagnosis and management of diabetes mellitus are being revised and will be released next year. In a virtual session at the AACC meeting in September, laboratorians got a look at some of the recommendations to come.
Read More »1- or 2-step: Outcomes studied in GDM screening
June 2021—If screening for gestational diabetes mellitus were a dance competition, it might have a contest between quickstep and paso doble as its signature event. That tournament could pit the one-step testing protocol (twice as likely to diagnose GDM) against the two-step testing protocol (significantly easier for pregnant women to adhere to).
Read More »Higher CVD risk, or lower risk? hs-cTn in diabetes
October 2020—When Elizabeth Selvin, PhD, MPH, of Johns Hopkins Bloomberg School of Public Health, began her studies of high-sensitivity cardiac troponin assays, they had not yet been approved in the U.S., as they are now, for use in diagnosing myocardial infarction. But some of her studies and those of Amy K. Saenger, PhD, DABCC, medical director of clinical laboratories and director of clinical chemistry at Hennepin County Medical Center in Minneapolis, take high-sensitivity cardiac troponin in a new direction by exploring its potential use as an aid in monitoring cardiovascular risk in the general population.
Read More »A preanalytical Rx for fallible GDM testing
July 2020—Gestational diabetes mellitus, if left untreated, is notoriously dangerous for mothers and their babies, making timely diagnosis critical. Yet the disease is similarly well known for being chronically under-diagnosed by laboratory testing.
Read More »Biomarker screen makes case for MODY genetic testing
February 2020—Cost-effectiveness analysis of health care diagnosis and treatment, unfortunately connoting quotas and spartan budgets, may not have the best reputation among the general public.
Read More »For gestational diabetes, one step or two?
December 2019—The controversy surrounding the approved methods for screening gestational diabetes mellitus took the form of a debate at this year’s AACC annual meeting, with two speakers defending the one-step or two-step method.
Read More »Diagnosing GDM in the first trimester
December 2019—“If you thought that diagnosing gestational diabetes at 24 to 28 weeks was unsettled, you haven’t seen anything yet.” That was David B. Sacks, MB, ChB, of the National Institutes of Health, speaking this year in the AACC session on gestational diabetes mellitus (GDM) with his co-presenters who debated the use of the one-step and two-step methods for diagnosing GDM in the second and third trimesters (see story, page 1). His talk: “Let’s Not Wait: Diagnosing GDM in the First Trimester.”
Read More »Could CGM dethrone HbA1c for office-based diabetes care?
December 2018—A glucose sensor the size of a quarter placed on the body and a sensor filament inserted under the skin could potentially disrupt traditional diabetes care with its continuous monitoring of glucose almost 300 times a day. Blood glucose can fluctuate widely during the day even in completely healthy people, said David Sacks, MB, ChB, in an interview with CAP TODAY.
Read More »Serial NT-proBNP found to identify risk for adverse CV outcomes
August 2018—For diabetes type 2 patients with cardiovascular disease, findings of a new study support clinicians’ use of serial measures of NT-proBNP concentrations to make critical treatment decisions easier by basing them on risk of major cardiovascular events, including heart failure.
Read More »Inflammatory biomarkers foreshadow CKD, study finds
March 2018—The central idea of the film Minority Report—that a “precrime” police unit can predict and prevent crimes—still mostly inhabits the realm of science fiction. Luckily, in medicine, researchers studying “predisease” can make headway on prevention by analyzing the laboratory test results from samples collected years earlier, when patients showed no clinical symptoms, that might have been able to predict disorders such as chronic kidney disease (CKD) in those patients.
Read More »HbA1c shows its mettle in predicting diabetes risk
December 2017—The longitudinal Framingham Heart Study, which first identified the concept of risk factors and made serum LDL cholesterol a household name, could help increase the celebrity status of HbA1c, with the Oct. 26 publication of a new study in Diabetes Care. International and national organizations since 2010 have recognized HbA1c as a valid way to diagnose abnormalities in glycemia and diabetes mellitus. But there has been less consensus on its use as a screen for elevated diabetes risk.
Read More »Bringing data analytics to bear on diabetes care
September 2017—Can data move the dial on diabetes? That’s the thinking behind Roche Diabetes Care’s new partnership with Accenture, and it’s how some labs and health care systems are already driving diabetes care to a whole new level.
Read More »Study ‘opens the door’ to troponin, diabetes link
May 2017—Clinicians and laboratories have only begun to wade into the depths of the FDA’s long-awaited clearance of a new-generation, high-sensitivity cardiac troponin T (hs-cTnT) assay for rapid diagnosis of acute myocardial infarction. Roche’s Elecsys TnT Gen 5 STAT assay received just such clearance in January. Yet researchers are already deep into investigations that may float new opportunities for high-sensitivity troponin T testing to the surface of medical diagnostics.
Read More »As diabetic CKD takes toll, work on tests continues
September 2016—When nephrologist Katherine Tuttle, MD, first saw the photo of two women holding young children, she thought it captured the mother of the boy and girl sitting on a couch with the children’s grandmother.
Read More »Latest HbA1c debate examines race as nonglycemic factor
December 2015—In 2010, the American Diabetes Association endorsed the use of hemoglobin A1c to diagnose type 2 diabetes, and fierce arguments over the wisdom of that move have ensued ever since. A 2013 debate at the American Association for Clinical Chemistry’s annual meeting featured a spirited dialogue on the merits of using HbA1c as a diagnostic marker, compared with the traditional—and still ADA-recommended—alternatives, fasting plasma glucose and two-hour plasma glucose.
Read More »Diabetes debate: HbA1c or glucose?
February 2014—If it were a boxing match, the debate over whether hemoglobin should be used to diagnose diabetes would place the odds-on favorite in the “Yes” corner. In the “No” corner would be the underdog. At least based on the mainstream consensus since 2010, HbA1c for diagnosis is well established as an alternative to measuring glucose.
Read More »Order more tests? With diabetes, answer may be ‘yes’
March 2013—In patients with diabetes mellitus, hemoglobin A1c testing frequency is largely in line with recommended guidelines. In those same patients, LDL testing is not performed frequently enough, and urine protein testing frequency falls far short of recommendations.
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