DIABETES
Flagship HbA1c analyser from ARKRAY improves diabetes testing workflow
Pathology in Practice asked ARKRAY general manager David Eyre to provide insights into overall trends while assessing the current UK situation post-COVID. He offers a solution for speeding up all HbA1c testing, increasing throughput for routine tests while reducing unnecessary testing for variants.
According to the latest edition of the International Diabetes Federation Atlas Report, 8.2% of the UK population aged 20–79 years has some form of diabetes, accounting for almost four million people.1
When just the incidence of type 1 diabetes in children and adolescents (0–19 years) is taken into account, it points out that the UK has some of the highest number of cases, in the top 10 worldwide, with almost 32,000 per annum. The UK is also fifth in the world for incidences of adult-onset type 1 diabetes, below Eritrea, Ireland, Sweden and Finland.
Impact of HbA1c testing Haemoglobin A1c is the gold-standard parameter in the monitoring of diabetic patients2
and increasingly in the
condition’s diagnosis, indicating how well the diabetes is being controlled. For a patient with diabetes, an ideal HbA1c level is 48 mmol/mol (6.5%) or below.3 For the initial diagnosis, it is generally accepted that an HbA1c ≥6.5% would be appropriate.4 However, the Atlas reports that the
pressure on healthcare budgets can in part come from people not having access to HbA1c testing and at risk of serious side effects. While near to 90% of cases that are currently undiagnosed are in low-
42
and middle-income countries, the report also indicates that even in high-income countries like the UK, almost a third (28.8%) of people may have undiagnosed diabetes. It estimates that the number of UK adults aged 20–79 with overall undiagnosed diabetes to be more than 921,000.
Even in countries like the UK with universal health coverage (UHC), diagnosis of type 1 diabetes may be delayed until the first hospital admission for diabetic ketoacidosis (DKA), sometimes with fatal results. This has prompted campaigns to increase awareness of type 1 diabetes among stakeholders and parents.
Increased risk from COVID-19 Unfortunately, COVID-19 totally disrupted the management of patient testing for diabetes. A UK population- based cohort study of more than three million people with diabetes revealed a sudden increase in overall mortality and COVID-related mortality in March 2020, with the greatest rise among those with type 1 diabetes.5 According to the IDF Atlas, data taken during the first wave showed that people with diabetes had a 3.6-fold higher likelihood of being hospitalised due to the SARS-CoV-2 virus compared to those
ARKRAY’s The Lab 001 POCT analyser, which can be used for screening and diagnosis.
without the condition, Further, infections and deaths per 100,000 are said to be consistently higher in countries that have a high prevalence of diabetes.6–8 During COVID, some clinics put testing on hold or increased the time span between appointments. In many cases patients themselves were reluctant to attend, delaying for up to a year and often longer, while others were not able to visit their GP to report worrying symptoms.
It is essential for clinicians and their laboratory colleagues to monitor HbA1c levels to avoid serious side effects, with their knock-on effect on clinical care costs, not to mention the impact on the patient’s quality of life. Even a slightly high HbA1c level puts the patient more at risk of developing serious complications.
SEPTEMBER 2022
WWW.PATHOLOGYINPRACTICE.COM
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
