Misdiagnosis risk with diabetes test

Using HbA1c alone to screen for type-2 diabetes risks misdiagnosing many people, a leading biochemist has warned.

HbA1c-only tests have been proposed by an international expert panel. If the WHO backs this view, the DoH and Diabetes UK will consider it too.

Eric Kilpatrick, consultant in chemical pathology at Hull Royal Infirmary, co-authored a BMJ article listing concerns with an HbA1c-only system.

In people of African, Mediterranean or south-east Asian heritage with diabetes, HbA1c can be inaccurate, the authors said. 'If HbA1c is the sole means of diagnosis ... we cannot identify wrongly diagnosed patients without additional expense, interpretation, and consent for haemoglobinopathy screening.'

Problems also exist with the standardisation of the HbA1c test, they pointed out.

'These issues, and the potential list of tests required in addition to HbA1c to ensure its accuracy, make the idea of fasting overnight for a glucose test much more appealing,' they argued.

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