Experts: A1c testing could help detect undiagnosed diabetes

Eliminating the need to fast may remove one barrier to early detection, but some question how significant this hurdle really is.

By Victoria Stagg Elliott, AMNews staff. June 16, 2008.

A blood test more often used to monitor the progress of diabetes should be considered as a screening and diagnostic tool to reduce the number of people who have the disease and don't know it, according to an expert panel convened to consider the question. The statement was published by the Journal of Clinical Endocrinology & Metabolism online May 6 and will appear in the July print edition.

"There are serious deficiencies in the current criteria for diagnosing diabetes, and these shortcomings are contributing to avoidable morbidity and mortality," said Christopher Saudek, MD, lead author and professor of endocrinology and metabolism at Johns Hopkins School of Medicine in Baltimore.

According to the Centers for Disease Control and Prevention, 6.2 million people have diabetes but have yet to be diagnosed. The paper advocates using A1c testing to reduce these numbers because, unlike other screening tools, it does not require fasting -- a usual testing prerequisite many consider an impediment to increased detection.

Those behind this article suggest that A1c would be useful particularly for those with minimal access to health care, because it could be carried out when they receive sick care without having them return the next day.

"A number of people don't have regular health care at all, and they have diabetes and they don't know it. They show up with a cough or sore throat or even for an emergency room visit," said David Edelman, MD, one of the authors and associate professor of internal medicine at Duke University in Durham, N.C. "It's that population that we are trying to reach."