New Diagnostic Tool for the Treatment of Diabetes

New Diagnostic Tool for the Treatment of Diabetes

NewDiagnostic Tool for the Treatment of Diabetes

NewDiagnostic Tool for the Treatment of Diabetes

Diabetesis a prevalent public health problem in today’s society. Accordingto statistics, 9.3 percent of the American population has diabetes,which makes it the seventh leading cause of death. Currently, anestimated 6.2 million people in America have undiagnosed diabetes(CDC, 2010). Detecting diabetes is usually the first step in ensuringthat the patient implements an appropriate lifestyle and carry outglycemic and non-glycemic interventions. Then again, it takes astandard time of seven years to diagnosis type II diabetes once itbegins. The duration delays the start of intervention actions, whichmakes it hard to prevent and slow the disease at an early stage.Hence, there is a growing popularity of testing diabetes and relatedconditions using diagnostic tools (American Diabetes Association,2010). The A1C tests have been acknowledged as a new diagnostic toolfor type II diabetes in adults. Accordingly, the A1C assay is widelyrecognized and used as the most reliable technique for assessingchronic glycemia.

TheA1C diagnostic tool involves using a little amount of blood to checkthe amount of red blood cells containing glucose molecules to reflectthe intensity of glucose in the blood. The A1C tool tests a mixtureof red cells to give a weighted average blood-glucose regulation overtwo to three months (CDC, 2010). When testing for diabetes, thehealth care professional is primarily concerned with identifying adisease state rather than establishing a reference interval forhealth. Particularly, it is focused on predicting a clinical outcome,which is later applied to the reference intervals and clinicaldecision restrictions. Diabetes treatment is altered depending on theA1C tests results that are expressed as the percentage of glycatedhemoglobin. Most people with diabetes target an A1C level lower thanseven percent. New recommendations indicate that a result of A1C toolof 5.7 to 6.4 percent places a person’s blood-glucose amount in thepre-diabetes range (Nathanet al., 2008).Alternatively, a level higher than 6.5 percent would indicatediabetes. Defining diabetes using A1C measurement results in a 3.6percent, which is much lower diabetes prevalence. When A1C is used asthe primary diagnostic measure, the Areas Under Curves (AUC) fordiabetes detection reduces to 0.67 and 0.55 for all glucoseabnormalities. A1C is better linked with chronic problems bydetermining diabetic glycemic levels through their association withretinopathy. Observational studies have indicated that retinopathyincreased with A1C levels around 6.5 percent (Nathanet al., 2008).

Forthose reasons, in 2010, the American Diabetes Association standardsof care for diabetes added hemoglobin A1C as an analytical tool fordiabetes and prediabetes. According to experts, the new approach canhave a wider application to reduce the delay in testing diabetes. Allthat would be required is to add a straightforward test to complementfasting glucose and oral glucose tolerance testing (American DiabetesAssociation, 2010). The A1C tests are being proposed to confirmspecific clinical practices. The new tool is used as a marker ofglycemic control in recognized diabetes. In a patient, the degree ofhemoglobin A1C formation is a direct function of the averageblood-glucose concentration. The A1C assay is significant to nursingpractice in several ways. When compared with the glucosemeasurements, the A1C tests have several advantages such asexpediency, less inconsistency, better preanalytical stability, andinternational standardization (Nathanet al., 2008).The A1C test does not require an individual to fast. Thus, it canencourage more people to be tested for type II diabetes, which willfurther lower the number of undiagnosed people (CDC, 2010).

Thenagain, the A1C diagnostic tool is too expensive compared to otherfasting plasma glucose. Despite its level of standardization, theguidelines do not adequately reflect the accuracy of A1C tests(Nathanet al., 2008).Besides, it does not associate directly with actual glucose levels.Moreover, if this new tool is not sensitive to identify when a personhas diabetes, it could fail to achieve the prevention goal or evendelay the diagnosis (CDC, 2010). It is also has a recognizeddiscordance between the A1C tests and other glycemic measures. Thus,if medical practitioners want to identify diabetes accurately toprevent or delay complications, it is vital that they address theselimitations of A1C tests (Nathanet al., 2008).Besides, A1C is only an alternative but not superior to bloodglucose, which leaves the health care professional to make thedecision of the best diagnostic tool for an individual.

Inconclusion, A1C is now formally approved in many countries as adiagnostic test for type II diabetes as well as for monitoringpurposes. The A1C test joins the category of fasting plasma glucoseand oral glucose tolerance test as analytical tools for diabetes andprediabetes. A change from glucose-based diagnosis to hemoglobin A1Cdiagnosis substantially reduces the ability to screen for glucoseirregularities. Therefore, the A1C assays have been submitted to verythorough testing based on the principles of evidence-based medicine.Particularly, the evidence base is interested in predicting clinicaloutcomes. Besides, preanalytical, analytical, biological parameters,cost, and accessibility have to be taken into consideration whenchoosing a diagnostic tool. Consequently, A1C is a favorable choicedue to its clear advantages over glucose though the clinicians haveto be aware of the series of caution when using A1C diagnostic tool.Accordingly, there is a need for more research on this new diagnostictool. Nonetheless, the A1C is rapidly becoming popular in manyWestern countries.

References

AmericanDiabetes Association. (2010). Diagnosis and Classification ofDiabetes Mellitus.DiabetesCare,33(1), 62-69. Retrievedfrom www.diabetes.org.

Centerfor Disease Control. (2010). DiabetesPrevention and Control.Retrieved from www.cdc.gov.

NathanD. M., Kuenen J., Borg R., Zheng H., Schoenfeld D., Heine R. J.(2008).Translating the A1C Assay into Estimated Average GlucoseValues. Diabetescare,31(8): 1473-1478.