Department of Chemical Pathology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
BMJ Open. 2013 Sep 23;3(9):e003411. doi: 10.1136/bmjopen-2013-003411.
To determine the potential of opportunistic glycated haemoglobin (HbA1c) testing of pathology samples to detect previously unknown diabetes.
Pathology samples from participants collected for other reasons and suitable for HbA1c testing were utilised for opportunistic diabetes screening. HbA1c was measured with a Biorad Variant II turbo analyser and HbA1c levels of ≥6.5% (48 mmol/mol) were considered diagnostic for diabetes. Confirmation of previously unknown diabetes status was obtained by a review of hospital medical records and phone calls to general practitioners.
Hospital pathology laboratory receiving samples from hospital-based and community-based (CB) settings.
Participants were identified based on the blood sample collection location in the CB, emergency department (ED) and inpatient (IP) groups. Exclusions pretesting were made based on the electronic patient history of: age <18 years, previous diabetes diagnosis, query for diabetes status in the past 12 months, evidence of pregnancy and sample collected postsurgery or transfusion. Only one sample per individual participant was tested.
Of the 22 396 blood samples collected, 4505 (1142 CB, 1113 ED, 2250 IP) were tested of which 327 (7.3%) had HbA1c levels ≥6.5% (48 mmol/mol). Of these 120 (2.7%) were determined to have previously unknown diabetes (11 (1%) CB, 21 (1.9%) ED, 88 (3.9%) IP). The prevalence of previously unknown diabetes was substantially higher (5.4%) in hospital-based (ED and IP) participants aged over 54 years.
Opportunistic testing of referred pathology samples can be an effective method of screening for diabetes, especially in hospital-based and older persons.
确定机会性糖化血红蛋白（HbA1c）检测病理样本以检测先前未知的糖尿病的潜力。
利用适合 HbA1c 检测的其他原因收集的参与者的病理样本进行机会性糖尿病筛查。使用 Biorad Variant II turbo 分析仪测量 HbA1c，HbA1c 水平≥6.5%（48mmol/mol）被认为可诊断糖尿病。通过审查医院病历和电话询问全科医生来确认先前未知的糖尿病状态。
医院病理实验室从医院和社区（CB）环境中接收样本。
根据 CB、急诊部（ED）和住院部（IP）组的血液样本采集地点确定参与者。在预测试中排除了以下情况：年龄<18 岁、先前诊断为糖尿病、在过去 12 个月中对糖尿病状态进行了查询、有怀孕的证据以及样本在手术后或输血后采集。每个个体参与者仅测试一个样本。
在采集的 22396 个血液样本中，有 4505 个（1142 个 CB、1113 个 ED、2250 个 IP）进行了测试，其中 327 个（7.3%）HbA1c 水平≥6.5%（48mmol/mol）。其中 120 个（2.7%）被确定为患有先前未知的糖尿病（11 个[1%] CB、21 个[1.9%] ED、88 个[3.9%] IP）。在年龄超过 54 岁的基于医院（ED 和 IP）的参与者中，先前未知的糖尿病的患病率明显更高（5.4%）。
机会性检测送检的病理样本可以是一种有效的糖尿病筛查方法，尤其是在基于医院的和老年人中。
