The undesirability of labelling someone Diabetic without measuring their glucose and the lack of concordance of HbA1c with dysglycaemia was pointed out very forcibly to the DH………………….who ignored it!

 

 

 

----- Original Message -----

From: [log in to unmask]">Harris Richard

To: [log in to unmask]">[log in to unmask]

Sent: Friday, February 26, 2010 2:30 PM

Subject: Re: Health Screening

 

Michael

 

Is the GP referring to this section of the NHS health check programme for vascular diseases, which contains an algorithm for 'diagnosis of diabetes' following BMI >30?

 

 

Several of our local GP surgeries have been following this and sending in HbA1c samples instead of fasting plasma glucoses, the chart states either is acceptable as a screen. It does then recommend an OGTT if Hba1c 42 - 48mmol/mol but it’s still possible to measure Hba1c on 2 separate occasions and if both are >48mmol/mol (6.5%) in a non symptomatic patient with a BMI >30 then a diagnosis of diabetes can be made!!

 

Are other members aware of this? How were the cut off values determined? What advice can you give when guidelines have been published by DOH?

 

Richard

 

Dr Richard Harris

Senior Biochemist

Kettering General Hospital

 

-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Colley, Michael
Sent: 24 February 2010 17:17
To: [log in to unmask]
Subject: Re: Health Screening

 

I've just been informed by a GP that they've been instructed to measure

HbA1 in patients with high BMI as a screen for Diabetes.

 

I was under the impression that HbA1 was so variable between individuals

that it had not been shown to be useful for screening (except in the USA

!!).

 

Have I missed out on a change of opinion about its usefulness?  Can

anyone give me references?

 

Michael

 

 

Dr C M Colley

Consultant Chemical Pathologist

Great Western Hospital

Swindon  SN3 6BB

 

 

 

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