Blood Test Given in Doctor's Office May Detect Diabetes

Originally Published MDDI February 2002

R & D DIGEST

Because diabetes may go undetected for many years, damaging organs throughout the body before symptoms appear, early screening and detection is considered essential. In fact, undiagnosed diabetes is estimated to affect approximately 2% of the overall population. Results of recent studies now suggest that a simple blood test given in a doctor's office is capable of identifying patients with previously undetected diabetes. The findings also suggest that three easily assessed risk factors—obesity, high blood pressure, and family history—can be used to identify the best candidates for the screening test.

According to David Edelman, MD, of the Durham Veterans' Affairs Medical Center (Durham, NC) and Duke University Medical Center, current screening procedures for diabetes have not been proven cost-effective, and community-wide screening sessions where these procedures are used do not always result in medical follow-up with individual physicians. Such tests, which rely on blood sugar testing, also require several hours of fasting and thus cannot always be administered on the spot.

Edelman and his colleagues believe their new screening method may provide advantages in both cost-effectiveness and practicality. They selected a nonfasting test, HgA1c, that accurately indicates blood sugar levels over the previous two to three months and can detect at least 75% of diabetes cases. The test was administered to 1253 patients, primarily men between the ages of 45 and 64, during regular visits to their physicians at a Veterans' Administration medical center. A more-definitive fasting glucose test was administered to as many participants as possible that scored high on the first test.

The researchers found that 4.5% of the study participants had diabetes that had gone undetected despite receiving regular medical care. The researchers say this figure is similar to nationwide estimates of undiagnosed diabetes among men of this age.

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