Addition of a new test for diagnosing diabetes
A test called HbA1c used to check how well the blood sugar was being controlled over previous 2-3 months has now been approved as a diagnostic test. A report on a World Health Organisation (WHO) expert consultation issued recently on the diagnosis of diabetes recommends the acceptability of glycated haemoglobin, or HbA1c, as an additional test to diagnose the debilitating and deadly disease. Experts from WHO say the addition of a new test for diagnosing diabetes is a positive development.
The test has some advantages over traditional glucose measuring test. Unlike other methods, it does not require a patient to fast before a blood sample is taken, nor to consume a glucose drink that many people find unpalatable. It also has the advantage of reflecting a person's average blood glucose levels over the last 2-3 months. But the greatest challenge of implementing the test for diagnosis in a developing country like Bangladesh is its higher cost.
It also remains unreliable in medical conditions such as haemolytic (disease caused by destruction of red blood cells) or iron deficiency anaemia (reduced haemoglobin in blood). So the priority for low-income countries will continue to be ensuring the availability of blood glucose measurement at the primary health care level before widely introducing HbA1c for diagnosing diabetes.
HbA1c has been widely used since the 1980s as an indicator of blood sugar control. Experts opined that before using HbA1c as a diagnostic tool, the test should be standardised using latest technology so that results are not affected by any condition.
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