DIABETES


HA-8180V will be able to integrate into automation tracks of NHS pathology networks. It already offers large sample capacity solutions as a standalone system in the NHS.


While every manufacturer wants to


increase sales, ARKRAY’s solution offers such performance benefits that it appeals to the current trends towards establishing larger pathology networks that have to be mindful of operating costs for the longer-term. When a network upgrades to ARKRAY it can service higher workloads on fewer instruments in each laboratory. Samples can also be centralised into the hub where instruments running 80% of samples in FAST mode can easily handle expanding workloads. Data from the IDF Atlas report makes it clear that the overall cost to the NHS due to all aspects of diabetes is one of the highest in the world, and yet the NHS spend on each patient is far less than most other countries in Europe. We can extrapolate that some of the former UK costs refer to treating patients who have gone undiagnosed until DKA or other serious side effects emerge. No-one questions the value of HbA1c testing, but the NHS pathology service cannot be expected simply to handle the ever-increasing demand for more testing – however important this is to improving patient care – without looking for support from manufacturers like ARKRAY. For a modern diabetes testing service to cope with increasing capacity, innovative technology must be available to deliver faster turnaround times, greater workflow efficiency, and solutions that free valuable staff time. But these solutions must also offer gold-standard accuracy in the laboratory or out in the community.


References 1 International Diabetes Federation. IDF


Diabetes Atlas 2021. (www.diabetesatlas. org/en/).


2 Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights 2016; 11: 95–104. doi: 10.4137/BMI.S38440. eCollection 2016.


3 Diabetes UK. Living with diabetes. (www. diabetes.org.uk/guide-to-diabetes/).


4 World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. Geneva: World Health Organization, 2006 (https://apps. who.int/iris/handle/10665/43588).


5 Holman N, Knighton P, Kar P, O’Keefe J, Curley M, Weaver A. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England:


44 A FAST mode Variant mode


Mean (mmol/mol) CV-within run (%) CV-between run (%) CV total (%)


Mean (mmol/mol) CV-within run (%) CV-between run (%) CV total (%) Mean (%)


Variant mode B FAST mode


CV-within run (%) CV-between run (%) CV total (%) Mean (%)


CV-within run (%) CV-between run (%) CV total (%)


Control L Control H 33.76 0.59 0.35 0.63


102.92 0.56 0.31 0.58


31.61 0.50 0.45 0.64 5.24 0.31 0.17 0.33 5.04 0.32 0.28 0.40


98.11 0.28 0.32 0.41


11.57 0.45 0.23 0.47


11.13 0.22 0.25 0.32


Pool 1 36.21 0.67 0.28 0.66


35.80 0.30 0.41 0.49 5.46 0.40 0.18 0.40 5.43 0.17 0.20 0.26


Pool 2 55.12 0.45 0.23 0.47


55.05 0.30 0.21 0.34 7.19 0.31 0.17 0.33 7.19 0.22 0.15 0.25


Pool 3 76.15 0.51 0.37 0.58


76.05 0.21 0.17 0.26 9.12 0.38 0.30 0.45 9.11 0.16 0.12 0.19


Table 1. Reproducibility of HbA1c assay by ADAMS A1c HA-8190V operating in Variant and FAST mode.


a population-based cohort study. Lancet Diabetes Endocrinol 2020; 8 (10): 823–33. doi: 10.1016/S2213-8587(20)30271-0.


6 Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta- regression. Diabetes Metab Syndr 2020; 14 (4): 395–403. doi: 10.1016/j. dsx.2020.04.018.


7 Zhang Y, Cui Y, Shen M et al. Association of diabetes mellitus with disease severity and prognosis in COVID-19: A retrospective cohort study. Diabetes Res Clin Pract.2020; 165:108227. doi: 10.1016/j.diabres.2020.108227.


8 Killerby ME, Link-Gelles R, Haight SC et al.; CDC COVID-19 Response Clinical


Team. Characteristics associated with hospitalization among patients with COVID-19 – Metropolitan Atlanta, Georgia, March–April 2020. MMWR Morb Mortal Wkly Rep. 2020; 69 (25):790–4. doi: 10.15585/mmwr.mm6925e1.


9 National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management. NICE guideline [NG17]. London: NICE, 2022 (www.nice.org.uk/guidance/ng17/ifp/ chapter/having-your-blood-glucose- checked-hba1c).


10 Paleari R, Ceriotti F, Mosca A. Performance evaluation of ARKRAY HA-8190V system for measuring glycated hemoglobin. Biochim Clin 2022; 46 (1): 68–73 (https:// bc.sibioc.it/bc/autore/cognome/Ceriotti/ qualeautore/2830).


Diabetes costs and incidences


Globally, more than one in 10 adults are now living with diabetes, with some countries reporting upwards of one in five of the adult population with the condition.1 Furthermore, Europe as a whole has the second highest estimated number of diabetes-


related deaths among the 20–79 age group – approximately 1.1 million deaths. The countries with the lowest proportion of total deaths are Russia and the Czech Republic, each of which has the lowest, with approximately 1% of total deaths. The IDF warns that overall, diabetes is one of the fastest growing conditions, with huge implications for healthcare costs, It projects that diabetes prevalence (9.2%) and the number of people with diabetes (61 million) in the EUR region will see a 13% increase by 2045. The EUR region has the highest number of children and adolescents with type 1 diabetes (295,000) as well as the highest incidence annually, with 31,000 new cases per year. When the report looked at countries where total 2021 spending was ‘due to diabetes’


(referring to both forms), the UK was one of the top countries or territories with the highest total health expenditure (USD billion) for people aged 20–79, hitting $23.4 billion. France spends only slightly less at $22.7 billion, with Germany far exceeding both countries, at $41.3 billion. However, when costs are analysed in a different way – from the perspective of the amount spent per person, across the same age group – the UK spends far less than most other European countries, with a spend of around $5.86 million for 3,986,300 cases. In contrast, spending per person in nine other European countries overshadows the UK figure. Switzerland tops the spend with $12,828,000 on 389,000 incidences, while Sweden spends $7,675,000 on around 496,000 incidences.


SEPTEMBER 2022 WWW.PATHOLOGYINPRACTICE.COM


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