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By Serena Gordon
HealthDay Reporter
MONDAY, March 25, 2019 (HealthDay News) – A new study suggests that a commonly used diabetes test might not detect the disease as well as an older test test.
The researchers said the most recent test – called hemoglobin A1C – did not cover three-quarters of the diagnoses of diabetes discovered by the older test – called the oral glucose tolerance test.
"Diabetes is a global epidemic, since the incorporation of A1C [as a test for diagnosis] in 2010, we are relying on it more and more for its convenience, because patients do not have to be quick. But this is not a perfect test, "said Maria Mercedes Chang Villacreses, author of the study, who is a researcher in endocrinology at the National Medical Center in Hope, Los Angeles.
The oral glucose tolerance test "is more tedious, but it gives a more precise idea of the patient's physiology," she added.
"If you have a patient for whom you have risk factors for diabetes or you have a strong suspicion of diabetes, you should go ahead and do what is necessary." [glucose tolerance test]. If you rely solely on A1C, you may miss an opportunity to intervene sooner, "she said .This is important because good diabetes management can help to prevent the complications of the disease.
However, not everyone shares his concern about the use of the A1C test.
Dr. Joel Zonszein, director of the Diabetes Treatment Center at Montefiore Medical Center in New York, pointed out that "A1C has been approved for the diagnosis and treatment of diabetes." It's a very practical test, but not perfect A random test The A1C test gives us enough information to diagnose diabetes.This is a good tool. "
He added that the tests available to diagnose and manage diabetes all have advantages and disadvantages. "It's not what's better, they give us each different information," he said.
According to the US National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK), three types of blood tests can be used to look for diabetes: A1C, a fasting blood test or a random blood test. The A1C allows doctors to get an idea of your blood sugar over a period of two to three months. Random and fasting blood tests show your doctor what your blood glucose is at a given time.
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Fasting is not required for either the A1C test or the random blood test.
The oral glucose tolerance test is generally used to diagnose diabetes during pregnancy (gestational diabetes), said NIDDK. The test requires you to fast for at least eight hours. Then, your blood glucose is measured when you arrive at the doctor. You then drink a sweet liquid and wait. Your blood sugar will be checked again, often several times. The test can last between one hour and three hours.
"A glucose tolerance test is expensive and very inconvenient for patients," said Zonszein. He said the test is used during pregnancy and for research studies.
The current study involved 9,000 people over 20 years old. Study participants had both an A1C test and an oral glucose intolerance test.
The researchers said that the A1C test missed the diagnosis of diabetes in 73% of the cases detected by the glucose intolerance test.
The researchers do not know exactly why there was such a difference. There are known issues with the A1C test. The test gives slightly different results among blacks and some Hispanic groups. In addition, according to Chang Villacreses, results in A1C may not be reliable in people with anemia or certain blood disorders.
The American Diabetes Association has reiterated its recommendations that the fasting glucose test, A1C and OGTT are all "appropriate for diagnostic tests".
"Although the question of using the A1C vs OGTT test as the primary diagnostic tool for type 2 diabetes has also been the subject of professional debate for a number of years, this retrospective analysis does not in no way amends the recommendations of the American Diabetes Association and confirms many previous observations and studies, "said Dr. William Cefalu, scientific, medical and mission leader of the ADA.
The results were presented Saturday at the annual meeting of the Endocrine Society, ENDO 2019, in New Orleans. The results presented at the meetings are generally considered preliminary until they have been published in a peer-reviewed journal.
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