024 - The laboratory in diabetes: update
Autor(s): M. Carta
Issue: RIMeL - IJLaM, Vol. 6, N. 3-S1, 2010 (MAF Servizi srl ed.)
Page(s): 24-25
In a recent report, an international expert committee recommended the use of HbA1c test to diagnose diabetes and the American Diabetes Association approved the decision. HbA1c has several advantages to fasting plasma glucose, such as greater preanalytical stability, less day-today perturbation during periods of stress and illness. Nevertheless, this test has limitations: the presence of hemoglobin variants or any condition that may change red cell turnover will lead to spurious results. Another important change on diabetes management is related to the screening of gestational diabetes. The recent Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, a large multicenter multinational blinded trial, described a strong continuos association between maternal glucose concentration and increasing birth weight and markers of perinatal complications. The HAPO study used a 2-hour 75 g glucose load with no preliminary screening based on either risk factors or a challenge test. These results have led to careful reconsideration of the diagnostic criteria for gestational diabetes mellitus (GDM).