Routine blood test may identify people with pre-diabetes, cutting later treatment costs

January 6, 2011, Indiana University School of Medicine

A simpler form of testing individuals with risk factors for diabetes could improve diabetes prevention efforts by substantially increasing the number of individuals who complete testing and learn whether or not they are likely to develop diabetes.

Approximately 60 million Americans, one-third of the adult population, are pre-diabetic. Thirty percent of these individuals will develop Type 2 in less than a decade, yet most don't know they are at high risk for the disease.

A study published in the January 2011 issue of the reports that the hemoglobin A1c test, a common blood test that can be quickly administered in a physician's office, accurately and easily identifies pre-diabetics.

The A1c test measures average blood glucose level over the past 8 to 12 weeks and does not require a person to return for additional testing after an overnight fast. Researchers, led by Ronald T. Ackermann, M.D., M.P.H., associate professor of medicine at the Indiana University School of Medicine and a Regenstrief Institute affiliated scientist, report that the A1c blood test, which has been routinely administered to diabetic patients for many years, can also pinpoint pre-diabetes.

"Identifying more individuals with pre-diabetes through a simple test in a physician's office gives us a real opportunity to halt progression to the disease, which is clearly a win-win situation," said Dr. Ackermann.

"If you have or heart disease, or multiple other risk factors such as obesity, are over the age of 45, had a past episode of diabetes during pregnancy, or have a family history of the disease, your physician can administer a simple blood test which will show if you are pre-diabetic. If you are pre-diabetic, loosing as little as 10 to 15 pounds through diet and exercise can cut in half your chances of getting diabetes, greatly improving your health and lowering your need for health care," said Dr. Ackermann, who is associate director of the Diabetes Translational Research Center at the IU School of Medicine and director of the Indiana Clinical and Translational Sciences Institute Community Health Engagement Program.

Fasting tests, which are currently used to screen for pre-diabetes are difficult to administer primarily because they usually require two visits to the physician's office and because patients often forget to arrive on an empty stomach when they return for the test. The A1c test can avoid both of these problems because it can be performed on a single visit, even if a person has eaten. It is estimated that currently only 7 percent of all Americans with pre-diabetes have been tested and are aware of their status.

"Type 2 diabetes is growing rapidly with the increasing rate of obesity and has reached epidemic proportions in this country. Identifying pre-diabetics and halting the disease could prevent millions of individuals from developing diabetes and would avert the very high future costs of treating it. Lifestyle interventions in the pre-diabetic stage offer benefit not only by preventing but also by reducing cardiovascular risk factors," said Dr. Ackermann.

In 2002, the Diabetes Prevention Program, a large clinical trial, determined that diet and exercise sharply lower the risk that a person with pre-diabetes will develop diabetes. In a 2006 study Dr. Ackermann reported that it would be cost effective for Medicare to pay for diabetes prevention at age 50 rather than to deny prevention benefits until age 65 when many individuals will have already developed the disease.

Since that 2006 study, health insurance companies have taken a much closer look at paying for structured diabetes prevention programs as a means to improve health and to help curb the runaway costs of health care. In 2010, the UnitedHealth Group, a large nationwide health insurance carrier, began paying for a diabetes prevention program offered by the YMCA of the USA. The health plans, however, only pay for this treatment when a shows pre-diabetes.

"Since health plans are beginning to pay for pre-diabetes treatments, doctors now have a more compelling reason to encourage patients who have risk factors to complete a screening test," said Dr. Ackermann. "The more practical A1c test could help doctors perform testing on a much larger scale than ever before."

Related Stories

Recommended for you

Ambitious global virome project could mark end of pandemic era

February 23, 2018
Rather than wait for viruses like Ebola, SARS and Zika to become outbreaks that force the world to react, a new global initiative seeks to proactively identify, prepare for and stop viral threats before they become pandemics.

Forecasting antibiotic resistance with a 'weather map' of local data

February 23, 2018
The resistance that infectious microbes have to antibiotics makes it difficult for physicians to confidently select the right drug to treat an infection. And that resistance is dynamic: It changes from year to year and varies ...

Scientists gain new insight on how antibodies interact with widespread respiratory virus

February 22, 2018
Scientists have found and characterized the activity of four antibodies produced by the human immune system that target an important protein found in respiratory syncytial virus (RSV), according to new research published ...

Study reveals how kidney disease happens

February 22, 2018
Monash researchers have solved a mystery, revealing how certain immune cells work together to instigate autoimmune kidney disease.

Past encounters with the flu shape vaccine response

February 20, 2018
New research on why the influenza vaccine was only modestly effective in recent years shows that immune history with the flu influences a person's response to the vaccine.

Building better tiny kidneys to test drugs and help people avoid dialysis

February 16, 2018
A free online kidney atlas built by USC researchers empowers stem cell scientists everywhere to generate more human-like tiny kidneys for testing new drugs and creating renal replacement therapies.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.