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March 03, 2008

Diabetes: American Diabetes Association Plans to Review Fasting Glucose Benchmark for Diabetes Diagnosis

Fasting glucose, a benchmark for diagnosing type 2 diabetes, has been questioned in a new report published in a recent addition of The Lancet.

Researchers of a new study say their findings "suggest that the criteria for diagnosing diabetes could need reassessment."

However, not everyone is on board with this recommendation, and an editorial published along with the study states that the report "raises more question than answers," and until a clear new guideline is adopted, "we are probably best sticking with what we know."

Retinopathy Review

The new report is based on data from three studies that together included 11,423 adults with type 2 diabetes in the U.S. and Australia. The reviewers included Tien Wong, MD, of the Centre for Eye Research Australia at the University of Melbourne.

After fasting, participants gave blood samples and received high-tech photos of their eyes to determine if they had any signs of damage blood vessels in the retina, called retinopathy.

Although results varied for each of the studies reviewed, most people didn't have retinopathy, which can be a common complication of type 2 diabetes. Interestingly, they did find that retinopathy occurred more frequently in people with higher fasting glucose levels. But there was no clear benchmark for fasting glucose levels among retinopathy patients.

Of those with retinopathy, 60% had a fasting glucose level outside the range currently used to determine type 2 diabetes, prompting the reviewers to question the use of that fasting glucose standard for type 2 diabetes diagnosis.

A New Discussion on Alternative Diagnostic Criteria

"While interesting," continue The Lancet editorialists, "Wong and colleagues' study offers no alternative criteria." They go on to suggest that doctors "perhaps should focus less on a single universal cutoff" and instead focus on individual risk factors for type 2 diabetes

In May, the American Diabetes Association and its partners from around the globe have planned a discussion on the matter, according to M. Sue Kirkman, MD, vice president for clinical affairs at the American Diabetes Association.

Posted by Laura on March 3, 2008 | Permalink


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