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[交流] Hb A1C------专家建议筛查诊断糖尿病新指标

Panel Recommends Using Hb A1C to Screen for Diabetes
BALTIMORE, Md -- July 31, 2008 -- The haemoglobin (Hb) A1C test may have far wider use in identifying millions with undetected diabetes, according to a study in the July issue of the Journal of Clinical Endocrinology and Metabolism.
"The test is a measure of long-term glucose control, but doctors don't typically use it to screen for or diagnose the disease," said Christopher Saudek, MD, Johns Hopkins University School of Medicine and Johns Hopkins Comprehensive Diabetes Center, Baltimore, Maryland.
"There's reason to believe it could help identify many of the estimated 6 million people in the United States who have diabetes but don't know it."
The current screening and diagnostic tests are accurate only if patients fast for at least 10 hours before the test. Therefore, the test might miss a significant portion of people who have diabetes or who are at high risk for developing the disease since glucose levels will vary depending on diet and exercise regimen for several days leading up to the blood draw.
"If a patient is scheduled for a physical, he or she may 'tune up' by changing the regimen for a few days and throw off their test results, causing doctors to miss the patient's usual pattern of high blood sugar," Dr. Saudek said.
Dr. Saudek and colleagues concluded that the Hb A1C test should be used as a front-line method for identifying patients with diabetes, especially for those at high risk for the disease. Since the test does not require fasting and isn't affected by short-term changes in diet and exercise, the Hb A1C test has significant advantages to current testing methods.
The consensus was reached by a panel of endocrinologists, pathologists, and internists who reviewed relevant published studies and available tests.
The panel recommends that individuals who score at least 6% on an Hb A1C test may have or be at risk for diabetes and should be tracked with additional glucose or Hb A1C tests. Those who score between 6.5% or above, if confirmed, should be considered to have diabetes.
"This is a first step toward changing medical practice and could greatly enhance how well we're able to identify people with diabetes," said Dr. Saudek.
SOURCE: Johns Hopkins Medical Institutions
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