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Sacks, Arnold, Bakris, Bruns, Horvath, Kirkman, Lernmark, Metzger, and Nathan: Translation: Executive Summary: Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus*
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Clinical Chemistry
Laboratory Medicine Online

Laboratory Medicine Online 2011; 1(4): 173-178.

Published online: 7 October 2011

DOI: https://doi.org/10.3343/lmo.2011.1.4.1

Translation: Executive Summary: Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus*

David B. Sacks1, Mark Arnold2, George L. Bakris3, David E. Bruns4, Andrea Rita Horvath5, M. Sue Kirkman6, Ake Lernmark7, Boyd E. Metzger8, David M. Nathan9

1Department of Laboratory Medicine, National Institutes of Health, Bethesda, MD, USA.

2Department of Chemistry, University of Iowa, Iowa City, IA, USA.

3Department of Medicine, Hypertensive Disease Unit, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, IL, USA.

4Department of Pathology, University of Virginia Medical School, Charlottesville, VA, USA.

5Screening and Test Evaluation Program, School of Public Health, University of Sydney, SEALS Department of Clinical Chemistry, Prince of Wales Hospital, Sydney, Australia.

6American Diabetes Association, Alexandria, VA, USA.

7Department of Clinical Sciences, Lund University/CRC, Skane University Hospital Malmö, Malmö, Sweden.

8Division of Endocrinology, Northwestern University, The Feinberg School of Medicine, Chicago, IL, USA.

9Massachusetts General Hospital and Harvard Medical School, Diabetes Center, Boston, MA, USA.

Translator: Sa-Il Chun. Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. (sailchun@amc.seoul.kr). This article is translated from an English language article, originally published in Clinical Chemistry under agreement between the publishers of Laboratory Medicine Online and Clinical Chemistry. Acknowledgement and other information that is not directly related to the content of the article has not been translated, and thus omitted in this article. References are listed as they were in the original work. Original copyright © 2011 American Association for Clinical Chemistry, Inc.

Received 24 August 2011       Revised 24 August 2011       Accepted 24 August 2011

© 2011, Laboratory Medicine Online

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Multiple laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially.

Approach

An expert committee compiled evidencebased recommendations for the use of laboratory analysis in patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. A draft of the guidelines was posted on the Internet, and the document was modified in response to comments. The guidelines were reviewed by the joint Evidence-Based Laboratory Medicine Committee of the AACC and the National Academy of Clinical Biochemistry and were accepted after revisions by the Professional Practice Committee and subsequent approval by the Executive Committee of the American Diabetes Association.

Content

In addition to the long-standing criteria based on measurement of venous plasma glucose, diabetes can be diagnosed by demonstrating increased hemoglobin A1c (HbA1c) concentrations in the blood. Monitoring of glycemic control is performed by the patients measuring their own plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed.

Summary

The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.

Notes

This article is available from http://www.labmedonline.org

References

1. International Diabetes Federation. Diabetes atlas. 2008. 3rd ed. Brussels (Belgium): International Diabetes Federation.
2. Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, et al. Full accounting of diabetes and pre-diabetes in the US population in 1988-1994 and 2005-2006. Diabetes Care. 2009. 32:287–294.
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3. Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009. 301:2129–2140.
4. Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010. 362:1090–1101.
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5. American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care. 2008. 31:596–615.
6. Nathan DM. Long-term complications of diabetes mellitus. N Engl J Med. 1993. 328:1676–1685.
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7. Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, et al. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care. 2005. 28:2130–2135.
8. Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, McDonald JM, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002. 48:436–472.
crossref
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