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1-15 June, 2008  
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HbA1c—effective way of controlling diabetes

Tests like HbA1c help diabetes patients to control their plasma sugar levels more effectively. Suja Nair gets more details at a recently held Bio Rad Laboratories seminar

Diabetes can lead to complications if regimen is not followed properly, however, with effective control one can definitely avoid these complications. One should never compromise the quality of life and that is what the third annual seminar on diabetes and HbA1c organised by Bio Rad Laboratories focused on. The seminar centered on innovation in diagnostics and HbA1c test as a mechanism to fight against the disorder. It also shed light on the importance of A1c and how essential it is to know the history of the patient.

One of the key speakers who captured the attention by giving the view of medical practitioners was Dr M C Deepak, Consultant Diabetologist, Madhav Diabetes Centre, Chennai. He focused on the importance of how Hb1Ac acts as an effective tool in controlling diabetes. He said, "Though Hb1Ac is not used as the tool for detection of diabetes, there are a lot of studies that are beginning to show that HbA1c could probably be specific and as sensitive as fasting plasma glucose for the screening of type-2 diabetes."

Deepak added that the Bio Rad D10 machines is FDA approved technology and follows the protocol that was done in a landmark trail in the US, known as the diabetes complications control trail (DCCT). The study was done on about 1,441 patients from 1977 to 1991 for about 14 years on people with type 1 diabetes.

The study found that for every one percent reduction in HbA1c one was actually able to reduce the risk of a vascular complication or a blood vessel complication by 33 percent. A good blood sugar report should be collaborated with a good HbA1c report, which is needed to be done just twice a year.

For a good control of diabetes just looking at the plasma glucose value is not enough; one should have an Hb1Ac less than seven percent. On the benefits of HbA1c, Deepak added, "If we look at any of the studies they show that the risks of complications caused by diabetes are all assessed by the level of HbA1c and not the level of plasma glucose. Plasma glucose tells you only what is being happening at that point of time, but A1c tells us about the backlog of the last 90 days. If you have to know whether your patient is complying with drug or insulin therapy you are giving him or was he going through his regimen properly then you have to go necessarily by an HbA1c."

Another speaker who represented the pathology fraternity was Dr Puneet Kumar Nigam, Vice President-CRL Operations, Vimta Labs. He opined that there are only few pathology labs in India that keep themselves updated on the global best practices. And as far as management of diabetes mellitus is concerned, HbA1c has no alternative. It remains the most accurate and reliable test to effectively and scientifically manage the disorder.

Speaking at the event, Dhiren Wagle, Country Manager, Bio-Rad Laboratories said, "Diabetes, being a chronic disorder with no proven cure calls for better management, the medical emphasis must be on timely testing of sugar levels in the blood." The cost of a D10 machine is 11 lakhs. However, the cost of doing a test is not above Rs 300 to 400. Apart from the D10 technology, Biorad also introduced the point of care testing. Elaborating further on the launch, Madhuri Mehra, Senior Product Manager-Clinical Systems Divisions added that launch of point of care testing is done with the aim to reach out to the clinicians and smaller labs in the city, as this technology is less expensive as it cost only Rs 60,000 and can be efficiently used as a time saving tool.

The seminar saw the presence of doctors, clinicians and many other eminent personalities who actively participated and shared their views regarding diabetes control. To control diabetes there should be co-operation from not only the patients, but also clinicians and doctors and a proper partnership between the two can make the difference. Moreover, the price of managing and controlling diabetes is far less than the cost of complications caused by uncontrolled diabetes.



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