Dear Richard,
I always recommend that diabetics have their lipids
measured on fasting samples particularly those prone to
hypertriglyceridaemia as it is impossible to monitor trigs
meaningfully if the samples are taken at random. Too often
changes are made to medication (usually the statin)
inappropriately on the basis of a post-prandial rise. As
the predominant particle is VLDL, the cholesterol is also
affected by variability although to a lesser extent. (Mind
you it doesn't stop my consultant diabetologist colleagues
doing random sampling, but then they never think far
enough ahead to get their patients to get samples taken
before they come to clinic so the results are available).
And yes, I do measure glucose in my diabetic patients -
they understand it better than HbA1c.
Trevor
Dr. T.A. Gray
Consultant Chemical Pathologist
Northern General Hospital
Sheffield S5 7AU
On Fri, 1 Aug 2008 14:11:47 +0100
"Mainwaring-Burton Richard (RGZ)"
<[log in to unmask]> wrote:
> I frequently add a comment to GP requests for glucose
>measurement on
> patients with DM indicating that the measurement is not
>necessary.
>
> I do not yet go so far as to mention waste of resources
>which might bite
> home when PBR appears.
>
>
>
> The request frequently accompanies an HbA1c request, but
>also seems, more
> often than not, to be requested with the patient
>fasting.
>
>
>
> My main concern is not principally for the cost of the
>assay, but for the
> well-being of the patient.
>
>
>
> Is it right that diabetic patient should be asked to :
>
> a) fast for an unnecessary test ?
>
> b) fast unnecessarily for a cholesterol (if they
>have remembered to
> ask for it as well) ?
>
>
>
> In fact should a diabetic patient be asked to fast at
>all ?
>
> with best wishes
> Richard
> Richard Mainwaring-Burton
> Consultant Biochemist
> Queen Mary's Hospital
> Sidcup, Kent
> 020-8308-3084
>
>
>
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