New Guidelines Issued for Diabetes Testing

New guidelines for laboratory testing in the diagnosis and management of diabetes patients have been established by members of the US National Academy of Clinical Biochemistry and the American Diabetes Association. They were published in the March 2002 issue of Clinical Chemistry .

Although diabetes testing is a rapidly growing area with multiple tests offered today, the quality of scientific data supporting the use of these tests varies widely, with some tests showing limited or no clinical value, say the authors. Thus, guidance is needed on which are the right tests to use, how to use them correctly, and generating results that are clinically relevant. The evidence-based guidelines access every analyte used and provide specific recommendations. Laboratory issues addressed include diagnosis and screening, monitoring, analytical considerations, and test interpretation.

Following are the major recommendations. Fasting plasma glucose should be measured in an accredited laboratory to establish the diagnosis of type 1 and type 2 diabetes. Portable meters should not be used to diagnose diabetes and have limited value in screening, but can be used for self-monitoring of glucose by patients taking insulin. Glycated hemoglobin should be measured at least biannually in all patients to document glycemic control. Annual microalbumin testing of patients without clinical proteinuria should begin in pubertal or postpurbertal individuals five years after diagnosis of type 1 and at the time of diagnosis of type 2 diabetes. All adults with diabetes should receive an annual lipid profile.




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