Overpowering diabetes with preventive healthcare

Richin Bhandavat, Marketing Manager, Point of Care Business Unit, Siemens Healthcare, India, explains how preventive healthcare could be key to curbing diabetes in India and explains the importance of tests like A1c to track people in the pre-diabetic stage and take remedial measures to prevent these patients from developing the disease

In India, about 63 million people are suffering from diabetes and this figure is likely to reach touch 80 million by 2025. Additionally, there exists a huge population in the pre-diabetic stage – a condition in which patients have high blood glucose level, but are not in the diabetes range. These people are at high risk of getting diabetes.

However, with the proliferation of technological developments, early diagnosis of this pre-diabetic state can give an indication if the patient is at risk and course correction can be done immediately to reverse the impact of this disease state. A test known as A1c can work wonders for pre-diabetic patients, to diagnose the risk level of getting diabetes.

What is A1c testing?

A1c is a simple test that can help to diagnose and control diabetes. The test measures an important diabetes indicator in blood called haemoglobin A1c (HbA1c). Patients with diabetes are advised to check their blood sugar at different times of the day, which is an easy and relatively cost-effective way to manage diabetes. In reality, blood-sugar levels change from minute to minute causing difficulty to gauge overall control using standard blood glucose meters. Many physicians thus, prefer to periodically check HbA1c levels.

With in-office testing and just one drop of blood, HbA1c tests can accurately measure overall blood glucose levels with immediate availability of test results. It is not only an important measurement for diagnosing diabetes, but can also be used for overall management of the disease. The biggest advantage with HbA1c testing is that it can be conducted any time and requires no patient preparation, unlike fasting plasma glucose (FPG) measurements, where it’s necessary to fast at least eight hours prior to testing.

A1c goals for patients with diabetes

Patients with diabetes should keep HbA1c levels below seven per cent to minimise the risk of diabetes complications. However, each patient is different and physicians will set the appropriate HbA1c goal. There are many side effects if diabetes is left undiagnosed, untreated, or poorly controlled.

These can include:

• Increased risk of heart disease and stroke
• Circulation problems and nerve damage, particularly in the feet
• Foot ulcers and complications that can lead to amputations
• Vision problems that can lead to blindness
• Increased risk of kidney disease and kidney failure

How does it work?

The HbA1c test measures the amount of sugar (glucose) that binds to haemoglobin. When a patient’s blood-sugar levels are consistently high, excess glucose molecules have the opportunity to attach to hemoglobin cells. These so-called glycated haemoglobin proteins stay in the body for the life of the red blood cell (about three to four months). Since it acts as a long-term indicator, glycated haemoglobin is a valuable gauge for diagnosing and managing diabetes.

Diabetes fast factS:

• An A1c test measures a patient’s average blood-sugar levels over the preceding three to four months!
• You don’t get diabetes from eating too much sugar. Genetics and culture, as well as obesity and lack of exercise, can play influential roles in diabetes risk.

HbA1c testing at the point of care

Benefits of point of care tests are umpteen, for both patients and physicians. These tests help save valuable time by consolidating patients’ visits. On the other hand, especially with A1c tests, physicians can avail results in minutes, immediately review them and discuss necessary adjustments to treatment plans. Moreover, only a single measurement is needed during HbA1c testing, as opposed to blood glucose testing, which involves serial blood draws over several hours.

Notably, in-office diabetes testing is expanding, considering the increasing incidences of diabetes in India. Very recently the medical community has recognised HbA1c’s clinical utility in the disease diagnosis, with convenience cited as a significant patient advantage.

HbA1c testing though commonly used to manage diabetes patients; it still needs more popularity in the physicians’ community.

References:
1. http://www.diabetesfoundationindia.org/