Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

By D. Sacks, M. Arnold, G. Bakris, D. Bruns, A. Horvath, M. S. Kirkman, Å. Lernmark, Boyd E. Metzger, D. Nathan. Diabetes Care, 2002

1,108 citations recorded by the source corpus.

BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (HbA1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA1c. 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 that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

Subfields: Endocrinology, Diabetes and Metabolism, Genetics, Nephrology

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In Endocrinology, Diabetes and Metabolism

1. V. Basevi
2. G. Bakris
3. Å. Lernmark
4. A. Classification

In Genetics

1. V. Basevi
2. A. Classification

In Nephrology

1. V. Basevi

Citations in the corpus

• Standards of Medical Care in Diabetes—2012 (2011, background): “By performing an A1C test, health providers can measure a patient’s average glycemia over the preceding 2–3 months (20) and, thus, assess treatment efficacy.”
• Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. (2002, methodology): “The prior version of these guidelines (14) contained short sections on amylin and leptin, both of which were the focus of active clinical studies.”
• The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care # (2015, methodology): “pdf [2] International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al.”
• Demonstrated brain insulin resistance in Alzheimer's disease patients is associated with IGF-1 resistance, IRS-1 dysregulation, and cognitive decline. (2012, background): “While the defining clinical feature of both T1D and T2D is hyperglycemia (153), there is no evidence that the brain in AD is hyperglycemic.”
• Standards of Medical Care in Diabetes—2009 (2009, background): “Because the accuracy of SMBG is instrument and user dependent (37), it is important to evaluate each patient’s monitoring technique, both initially and at regular intervals thereafter.”