Could there be 5 types of diabetes?

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Could there be 5 types of diabetes?

A peer-reviewed study, published in The Lancet Medical Journal suggests there are five types of diabetes. Could diabetes be more complex than we once thought? Could diabetes be segmented into five separate diseases?

 

What is diabetes?

Diabetes is an incurable disease which prohibits the body’s ability to produce and respond to insulin.  Currently, diabetes is classified into two main forms, type 1 and type 2.

Type 1 diabetes is an autoimmune disease which manifests in childhood.  In type 1 diabetes, the body’s white blood cells attack the insulin-producing cells in the pancreas.  As a result, individuals with Type 1 diabetes rely on the injection of insulin for the remainder of their lives.

Type 1 diabetes affects 10 percent of individuals with diabetes.  96 percent of children diagnosed with diabetes have type 1.  Type 1 diabetes in children is commonly diagnosed between the ages of 10 and 14.  The prevalence of type 1 diabetes in children and young people (under the age of 19) is 1 in every 430-530 and the incidence of type 1 in children under 14 years of age is 24.5/100,000 (Diabetes UK, 2014).

Type 2 diabetes is the result of insulin resistance, meaning that the pancreas does not produce enough insulin or the body’s cells do not respond to the insulin produced.  As type 2 diabetes is a mixed condition, with varying degrees of severity, there are a few methods to manage the disease, including dietary control, medication and insulin injections.

Type 2 diabetes is the most common form of diabetes, affecting 90 percent of individuals with diabetes, and has now become a global burden.  The global prevalence of diabetes has almost doubled from 4.7 percent in 1980 to 8.5 percent in 2014, with a total of 422 million adults living with diabetes in 2014.  It is expected to rise to 592 million by 2035.  In 2012, diabetes accounted for 1.5 million deaths globally with hypertension causing a further 2.2 million deaths.  43 percent of these deaths occurred before 70 years of age.  Previously type 2 diabetes was commonly seen in young adults but is now commonly seen in children as well.  In 2017, 14% more children and teenagers in the UK were treated for diabetes compared to the year before (World Health Organization, 2016).

In both forms of diabetes, hyperglycemia can occur which can lead to number of associated complications including renal disease, cardiovascular disease, nerve damage and retinopathy.

 

The novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables – peer-review study

This new research studied 13,270 individuals from different demographic cohorts with newly diagnosed diabetes, taking into consideration body weight, blood sugar control and the presence of antibodies, in Sweden and Finland.

This peer-reviewed study identified 5 disease clusters of diabetes, which have significantly different patient characteristics and risk of diabetic complications.  The researchers also noted that the genetic associations in the clusters differed from those seen in traditional type 2 diabetes.

Cluster One – Severe autoimmune diabetes (SAID)

SAID is similar to type 1 diabetes.  SAID manifests in childhood, in patients with a low BMI, have poor blood sugar and metabolic control due to insulin deficiency and GADA.  6% of individuals studied in the ANDIS study were identified with having SAID.

Cluster Two – Severe insulin-deficient diabetes (SIDD)

SIDD is similar to SAID, however, GADA is negative.  This means that the characteristics of SIDD are the same as SAID, young, of a healthy weight and struggled to make insulin, however, SIDD is not the result of an autoimmune disorder as no autoantibodies are present.  Patients have a higher risk of diabetic retinopathy.  18% of subjects in the ANDIS study were identified with having SIDD.

Cluster Three – Severe insulin-resistant diabetes (SIRD)

SIRD is similar to that of type 2 diabetes and is characterised by insulin-resistance and a high BMI.  Patients with SIRD are the most insulin resistant and have a significantly higher risk of kidney disease, and microalbuminuria, and non-alcoholic fatty liver disease.  15% of subjects in the ANDIS study were identified as having SIRD.

Cluster Four – Mild obesity-related diabetes (MOD)

MOD is a mild form of diabetes which generally affects a younger age group. This is not characterised by insulin resistance but by obesity as their metabolic rates are close to normal.  22% of subjects in the ANDIS study were identified as having MOD.

Cluster Five – Mild age-related diabetes (MARD)

MARD is the most common form of diabetes manifesting later in life compared to the previous four clusters.  Patients with MARD have mild problems with glucose regulation, similar to MOD.  39% of subjects in the ANDIS study were identified with having MARD.

This new sub-classification of diabetes could potentially enable doctors to effectively diagnose diabetes earlier, through the characterisation of each cluster, including: BMI measurements, age, presence of autoantibodies, measuring HbA1c levels, ketoacidosis, and measuring fasting blood glucose levels.  This will enable a reduction in the incidence of diabetes complications and the early identification of associated complications, and so patient care can be tailored, thus improving healthcare (NHS, 2018) (The Week, 2018) (Ahlqvist, et al., 2018) (Collier, 2018) (Gallagher, 2018).

The Randox diabetes reagents cover the full spectrum of laboratory testing requirements from risk assessment, using our Adiponectin assay, to disease diagnosis and monitoring, using our HbA1c, glucose and fructosamine assays, to the monitoring of associated complications, using our albumin, beta-2 microglobulin, creatinine, cystatin c, d-3-hydroxybutyrate, microalbumin and NEFA assays.

Whilst this study is valuable, alone it is not sufficient for changes in the diabetes treatment guidelines to be implemented, as the study only represents a small proportion of those with diabetes.  For this study to lead the way, the clusters and associated complications will need to be verified in ethnicities and geographical locations to determine whether this new sub-stratification is scientifically relevant.

 

References

Ahlqvist, E. et al., 2018. Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. [Online]
Available at: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30051-2/fulltext?elsca1=tlpr
[Accessed 16 April 2018].

Collier, J., 2018. Diabetes: Study proposes five types, not two. [Online]
Available at: https://www.medicalnewstoday.com/articles/321097.php
[Accessed 16 April 2018].

Diabetes UK, 2014. Diabetes: Facts and Stats. [Online]
Available at: https://www.diabetes.org.uk/resources-s3/2017-11/diabetes-key-stats-guidelines-april2014.pdf
[Accessed 16 April 2018].

Gallagher, J., 2018. Diabetes is actually five seperate diseases, research suggests. [Online]
Available at: http://www.bbc.co.uk/news/health-43246261
[Accessed 16 April 2018].

NHS, 2018. Are there actually 5 types of diabetes?. [Online]
Available at: https://www.nhs.uk/news/diabetes/are-there-actually-5-types-diabetes/
[Accessed 16 April 2018].

The Week, 2018. What are the five types of diabetes?. [Online]
Available at: http://www.theweek.co.uk/health/92048/what-are-the-five-types-of-diabetes
[Accessed 16 April 2018].

World Health Organization, 2016. Global Report on Diabetes, Geneva: World Health Organization.

If you are a clinician, dietitian or laboratory who are interested in running diabetes assays, Randox offer a wide range of high-quality routine and niche assays including: fructosamine, glucose, HbA1c for diagnosing and monitoring diabetes, albumin, beta-2 microglobulin, creatinine, cystatin c, NEFA, microalbumin, and d-3-hydroxybutyrate to monitor associated complications, and adiponectin  as a biomarker for diabetes risk assessment.  These assays can be run on most automated biochemistry analysers.

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.

For more information, visit: https://www.randox.com/diabetes-reagents or email: reagents@randox.com 


The Importance of Equine Health

With the Grand National around the corner, Randox Reagents have investigated the importance of equine health, focusing on racehorses.

Maintaining good health in racehorses is vital as proper management can reduce the incidence of many disease conditions.  Racehorses are bred, raised, and trained to perform as athletes. Therefore, it is vital that the performance health of racehorses is continually assessed to ensure that they are physically fit, happy and healthy.

 

Racehorse’s have a busy life.  They are broken in from 18 months of age, usually using traditional methods such as long reining, followed by accepting a rider and training alongside other horses.  At 2 years of age, the real training begins which focuses on fitness and speed rather than ‘schooling’ the horse in the conventional way.  This training is undertaken alongside another horse to teach the trainee horse how to race but at the same time, it is taught to settle and listen to the jockey.

In peak season, the horse’s weekly exercise regime consists of: two days of fast gallop work with steady trotting or cantering the rest of the week, with a rest day on Sunday’s (depending on races scheduled for the horse).

 

The most important bodily systems for top athletic performance in racehorses include:

Skeletal system (including bone, tendons and ligaments) problems such as torn or stretched ligaments or tendons or a broken bone will be very painful, inducing lameness and prohibiting performance

Muscles enable the horse to perform. Fatigued or damaged muscles will result in poor performance as the horse cannot generate enough energy and strength to maintain its high performance

Respiratory system (nasal passages, throat and lungs) problems prohibits the normal flow of oxygen through the body, which prohibits the energy required for exercise

Cardiovascular system (heart, blood vessels, volume of blood and red blood cells) problems prohibits the movement of oxygen from the lungs to the muscles, again prohibiting the generation of energy required for exercise.

Central nervous system (CNS) problems can result in the loss of coordination and the fine control that accompanies minor problems to the CNS can significantly prohibit exercise performance

 

Due to the intense training that racehorses undergo, it is vitally important that their health is continually assessed to diagnose and treat injuries and the jockey allows the horse time to recover from the injury.  The most common sites of injury include: forelegs, back and pelvis such as bowed tendon (tendonitis), strained suspensory ligaments, splints, osselets, sesamoid fractures, condylar fractures, knee fractures, bone chips, bucked skins and pin firing.  It is vitally important that racehorses are allowed time to rest and heal after an injury.  Training or racing a horse whilst injured can be detrimental.

 

Randox Equine Panel

Randox offer 10 scientifically proven assays for equine health which are made from the same high-quality material as our human assays, providing accurate and precise results.  These assays have extensive measuring ranges for the accurate detection of disease or inflammation which are suitable for use with serum, plasma and whole blood.  Instrument specific applications (ISA’s) are available for an extensive range of biochemistry analysers suitable for use with manual, semi-automated and fully automated analysers.

The Randox range of assays, suitable for equine use, cover a range of biomarkers:

Adiponectin is used to assess equine metabolic syndrome (EMS) which is characterised by obesity, regional adiposity, insulin resistance, and susceptibility to laminitis.  Laminitis is one of the most common causes of lameness in horses.  It is a painful and potentially crippling condition, which in severe cases usually results in the horse being humanely euthanised.

Aspartate Aminotransferase (AST) levels directly correlate with the severity of muscle inflammation or damage, or liver damage. The highest levels of AST will be seen around 24hours after muscle injury and persist for 2-3 weeks.

CK-NAC is a sensitive marker for the detection of musculoskeletal diseases; and is useful to assess the extent of severe muscle trauma, crush injuries, and burns and the likelihood of developing rhabdomyolysis.

For health professionals

If you are a veterinarian or laboratory who are interested in running equine assays, Randox offer a wide range of high-quality routine and niche assays including: albumin, alkaline phosphatase, bilirubin, calcium, GLDH, glucose and urea. These can be run on most automated biochemistry analysers.

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.

For more information, email reagents@randox.com

 


Looking after your kidney health during your pregnancy

With this year’s World Kidney Day theme focusing on women’s health and in particular, their kidney health, the campaign is drawing attention to the need for a higher awareness, timely diagnosis and proper follow-up of kidney issues amongst women.

One key area being highlighted by the campaign is the close links between pregnancy and kidney health problems.  The two are intrinsically connected – with CKD considered a high-risk factor for problematic pregnancies and reduced fertility, and in turn, pregnancy-related complications, including preeclampsia, can increase the risk of kidney disease.

Although not commonly known, women who have Chronic Kidney Disease are at increased risk of hypertensive disorders and premature births – which can be devastating for all involved.

Women with Chronic Kidney Disease who become pregnant also usually have mild kidney dysfunction, the severity of which will depend on the stage the CKD is at.

It is clear therefore that there is a need for increased awareness of Chronic Kidney Disease in pregnancy, to timely identify its existence before conception, and to monitor its progress before, during and after birth.

With a comprehensive panel of kidney health tests, Randox are working to ensure timely diagnosis of kidney function problems, to ensure that necessary treatment is administered at the earliest possible stage, when it is most likely to be successful.

Pregnant women, or women hoping to get pregnant in the future, can therefore determine their kidney health and be empowered to embark upon the necessary lifestyle changes or treatment required to ensure a safe and healthy pregnancy.

For example, the Randox test for albumin, low concentrations of which are the earliest marker of kidney damage, can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

In addition to albumin, there are a number of other highly specific and sensitive tests for kidney health, which are available as part of a Randox Health Check at our Randox Health Clinics. These include;

  • Estimated Glomerular Filtration Rate, which is an equation that considers age, gender, blood and protein levels to determine how well the kidneys are functioning.
  • Creatinine, which is a waste product produced by muscle tissue, and removed by the kidneys. When kidney function is diminished, creatinine levels increase.
  • Other proteins within the body which should be filtered by the kidneys, and are therefore measured to determine kidney function, include;

–              Cystatin C

–              Beta-2-Microglobulin

–              Microalbumin, which is not usually found in urine, but can appear when normal kidney function is impaired.

  • Minerals processed by the kidneys and analysed by Randox Health include;

–              Magnesium

–              Calcium

–              Phosphate

–              Potassium

–              Sodium

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With access to these high-performance kidney health tests, expectant mothers with kidney problems can be diagnosed early, before the condition develops into something more serious – keeping both you, and your baby healthy.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

 

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today. Speak to our team by phoning 0800 2545 130.

 

 

 


Randox Testing Services: Customer Testimonials from Ireland

At Randox Testing Services (RTS), we pride ourselves on helping our customers improve the health and safety of their working environment. Using our accurate and reliable testing methods and a range of additional services including training and policy reviews, we create tailored packages to meet the needs of our customers. We work with customers all over the world, but this month are highlighting the work we are doing across Ireland.

This month RTS will be attending the Northern Ireland Occupational Health, Hygiene and Wellbeing Conference at Titanic Belfast. This conference brings together companies from a range of industries all across Ireland to discuss the importance of employee health and wellbeing. As a company that began in Northern Ireland, RTS have always had strong connections with local businesses and are continually expanding our reach across Ireland.

Some of the companies with which we currently work, like GRAHAM construction, have recently provided feedback on our services. GRAHAM is based in Hillsborough, Co. Down and is a national construction, asset management and project investment business. They deliver services to a diverse range of clients from a network of regional offices, throughout the UK and Ireland.

GRAHAM Construction are proud to be partnered with Randox as their main Drug & Alcohol Service Provider. Over the years they have given a consistent, prompt, efficient, and professional service that delivered what was promised, when promised, to the proper agreed standards, which assists us in managing our relevant responsibilities with ease and confidence. I would have no hesitation in recommending them to others.”

This is great feedback to receive from such a reputable company who have a range of different testing needs. The construction industry is becoming more and more proactive when it comes to drug and alcohol testing. At RTS our experience working with GRAHAM and other major construction firms across the UK and Ireland means we are extremely well equipped to deal with the changing needs of this industry.

Another industry which requires a flexible and reliable drug and alcohol testing services provider is the aviation industry, especially when it comes to recruitment. We have been working with CAE Parc Aviation Services, the global leader in the provision of aviation personnel and support services to conduct pre-employment testing.

“We use Randox for Pre-Employment and Random Drug & Alcohol testing for select clients. We would happily recommend their services.”

Again, through working with various industries, the experience our staff possess is second to none. By qualifying the exact needs of our customers we create customised, cost-effective packages to ensure all testing needs are met.

As well as offering drug and alcohol testing services, our complete solution also includes a host of training, educational and consultancy services to equip our customers in tackling drug and alcohol misuse. Including comprehensive chain of custody training programs, which enables employers to conduct on-site collections to the same standard as a Randox Testing Services collection specialist.

The Henderson Group in Newtownabbey are another large company that has availed of the services offered by Randox Testing Services. The Henderson Group are the owners of the SPAR, EUROSPAR, ViVO, ViVOXTRA and ViVO Essentials franchises in Northern Ireland and have been distributing food and grocery-related products to the convenience retail sector for over 100 years.

“We switched provider for our Drug and Alcohol policy almost two years ago, moving to Randox.  The switchover was relatively seamless and the impact on our business has been positive.  Our tests are now all completed within target and we have realised a saving to boot.  We are glad we made the switch.”

 

 

Randox Testing Services is committed to tailoring our service to the needs of customers all over the world, and across the island of Ireland.

If your company would like to speak to us, please contact testingservices@randox.com

Alternatively you can contact David O’Regan, the Business Development Executive for Ireland directly: David.O’Regan@randox.com.

 

 


Take a proactive approach to your kidney health this World Kidney Day

On 8th March 2018, it’s World Kidney Day, a global campaign aimed at raising awareness of the importance of good kidney health. With a similar agenda to that of Randox, whose vision it is to ensure patients across the globe have access to the latest advancements in health technology, World Kidney Day works to reduce the frequency and impact of kidney disease and its associated health problems.

This year, the World Kidney Day theme is Kidneys and Women’s Health, to highlight that approximately 195 million women worldwide are affected by Chronic Kidney Disease. In 2018 World Kidney Day and International Women’s Day are recognised on the same date, offering the perfect opportunity to reflect on the importance of women’s health and specifically their kidney health.

CKD is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.

According to some studies, CKD is more likely to develop in women compared with men, with an average 14% prevalence in women compared to 12% in men.

However, the number of women successfully put on dialysis for their Chronic Kidney Disease is lower than the number of men – potentially due to slower progression of the disease, inequitable access to transplantation, and a general lower disease awareness.

It is therefore fitting that World Kidney Day has chosen Women’s Health as its theme for this year – due to the clear need for a higher awareness, timely diagnosis and proper follow up of kidney issues amongst women.

With a comprehensive panel of kidney health tests, Randox are working to ensure timely diagnosis of kidney function problems, to ensure that necessary treatment is administered at the earliest possible stage, when it is most likely to be successful.

For example, the Randox test for albumin, low concentrations of which are the earliest marker of kidney damage, can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

In addition to albumin, there are a number of other highly specific and sensitive tests for kidney health, which are available as part of a Randox Health Check at our Randox Health Clinics. These include;

  • Estimated Glomerular Filtration Rate, which is an equation that considers age, gender, blood and protein levels to determine how well the kidneys are functioning.
  • Creatinine, which is a waste product produced by muscle tissue, and removed by the kidneys. When kidney function is diminished, creatinine levels increase.
  • Other proteins within the body which should be filtered by the kidneys, and are therefore measured to determine kidney function, include;
  • Cystatin C
  • Beta-2-Microglobulin
  • Microalbumin, which is not usually found in urine, but can appear when normal kidney function is impaired.
  • Minerals processed by the kidneys and analysed by Randox Health include;
  • Magnesium
  • Calcium
  • Phosphate
  • Potassium
  • Sodium

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With access to these high-performance kidney health tests, patients with kidney problems can be diagnosed early, before the condition develops into something more serious.

Although end stage kidney failure affects only 0.05% of the general population, it commands between one and two billion pounds a year of the entire annual NHS budget. We know that loss of kidney function is devastating and hope our innovations can identify those at risk of kidney problems before they occur.

One such test for Chronic Kidney Disease risk measures levels of the protective hormone adiponectin, and is available exclusively at Randox.

Adiponectin can accurately assess levels of hidden and dangerous visceral fat within the body, which is the main cause of almost all the disorders associated with metabolic syndrome, including Chronic Kidney Disease. Assessing adiponectin can determine risk of CKD, as well as a range of other illnesses including prediabetes, cardiovascular disease and various cancers.

By using adiponectin to assess risk of kidney problems, we can empower individuals with the tools they need to prevent kidney problems in their future.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today. Speak to our team by phoning 0800 2545 130.

 


The Complete Solution to Cardiac Risk Assessment

“CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause”.  In 2015, roughly 17.7 million people died from CVD, representing 31% of all global deaths: 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. (WHO, 2017)

 

Cardiac health and regular cardiovascular screening is important to enable risk factors to be detected in their earliest stages.  There are a few factors which contribute to CVD.  These include: smoking, unhealthy diet, excessive alcohol consumption, low physical activity levels.  Whilst there are only a few factors contributing to CVD, these can be maintained by the patient through living a healthy lifestyle including: quitting smoking, consuming no more than the recommended allowance of alcohol, cutting out junk food, and exercising for 30 minutes a day, 3 – 5 days a week.  In a perfect world, this would be easy and CVD would not be a global problem.  However, due to busy lifestyles, cravings, reduced willpower, and convenience, not all individuals in today’s world will be able to avoid CVDs.  Therefore, it is vitally important that individuals are tested for CVDs to detect them in the earliest stages to reduce damage, prevent further damage, or even death.  Furthermore, many individuals suffer from inherited cardiac risk factors, which stresses the need for accurate testing of both traditional and novel cardiac risk biomarkers.

 

Randox offer the complete solution to cardiac risk assessment including: RX analysers, traditional and novel reagents, internal quality control (Acusera), and external quality control (RIQAS).

 

RX Series

Randox has developed the RX series range of clinical chemistry analysers for high-quality semi-automated and fully automated testing. Choose between the RX misano, RX monaco, RX daytona+, RX imola, and the RX modena depending on the throughput of your laboratory. The RX series offers a suitable analyser for your laboratory’s needs.  For more information on the Randox RX series, please click here or email therxseries@randox.com

 

Reagents

As previously mentioned, early assessment of cardiac risk is vital. Randox offer a range of novel risk biomarkers for both very early and the genetic assessment of cardiac risk.

The niche Adiponectin assay allows for the early assessment of CVD.  Adiponectin levels are inversely correlated with abdominal visceral fat which has proven to be a strong predictor of T2DM.  Body-Mass Index (BMI) is a common method for determining which patients are classified as underweight, healthy, overweight or obese, however, BMI does not take into account gender, ethnicity or activity levels.  For example, measuring the BMI of athletes who have a high BMI due to muscle weighing heavier than fat would classify them as obese which is inaccurate.  Measuring adiponectin levels is therefore a much more reliable indicator of at-risk patients compared to BMI.

LDL cholesterol is often referred to as the ‘bad cholesterol’.  High concentrations of LDL-cholesterol is considered to be the most important clinical predictor, of all single parameters, with respect to coronary atherosclerosis.  However, sLDL is a smaller, more dense subfraction of LDL-cholesterol.   sLDL particles more readily permeate the inner arterial wall and are more susceptible to oxidation.  Individuals with a predominance of sLDL have a 3-fold increased risk of myocardial infarction.  Measurement of sLDL allows the clinician to get a more comprehensive picture of lipid risk factors and tailor treatment accordingly.

Elevated levels of Lp(a) are considered to be both a casual risk factor and independent genetic marker of atherosclerotic disorders.  The major challenge associated with Lp(a) measurement is the size variation of apo(a) within Lp(a).  Dependent upon the size of apo(a) in the assay calibrator, many assays under or overestimate apo(a) size in the patient sample.  Numerous commercially available products suffer apo(a) size related bias, resulting in an over estimation of Lp(a) in samples with large apo(a)molecules and an under estimation in samples with small apo(a) molecules.  The antibody used in the Randox method detects the complete Lp(a) molecule providing accurate and consistent results.  This was proven by the IFCC who developed a gold standard ELISA reference assay and compared 22 commercially available tests.  The Randox Lp(a) method displayed the least (minimal) amount of apo(a) size related bias, proving it be a superior offering.

HDL3 Cholesterol is a smaller and more dense subfraction of the HDL particle.  HDL is the scavenger of cholesterol within arterial walls and the levels of HDL3 is too low, the ability to remove this cholesterol is reduced.  Therefore, it is widely accepted that there is an inverse correlation between HDL3 and CVD risk.

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

For more information on Randox Reagents, please click here or email reagents@randox.com

 

Acusera – Internal Quality Control

The Acusera cardiac controls have been designed to cover a wide range of cardiac markers at clinical decision levels, eliminating the extra expense of an additional low level control.  The controls are available in a both liquid ready-to-use and lyophilized formats making them ideal for all situations and manufactured from 100% human serum a matrix similar to that of the patient is guaranteed.  For more information on the Randox Acusera internal quality control, please click here or email acusera@randox.com

 

RIQAS – External Quality Control

The RIQAS Liquid Cardiac EQA programme is designed to monitor the performance of up to 9clinically significant cardiac markers including: CK-MB mass, D-dimer, Digoxin, homocysteine, hsCRP, myoglobin, NT proBNP, troponin I, and troponin T.  RIQAS is ISO/IEC 17043 accredited and allows the registration of up to five instruments at no extra cost.  All samples are 100% human serum and provided in a liquid ready-to-use format for enhanced convenience.  Submit your results bi-weekly and view reports online via RIQAS.Net.  For more information on RIQAS, the world’s largest international EQA scheme, please click here or email acusera@randox.com

 

For further information, please contact the Randox PR team via email: randoxpr@randox.com or phone 028 9442 2413

cardiac

 


Obesity: the disease, the problems, and the power of prevention

Earlier this year the World Obesity Federation made the stark statement that: “The early diagnosis and treatment of childhood obesity could be considered similar to vaccination.”

Essentially, they want to see this condition treated in the same way as chicken pox, measles and mumps: tackled – in the hope of eradication – by a strategic approach founded on proactive policies and early prevention.

Obesity in children and adolescents has risen tenfold in the last 40 years, according to a recent study by The Lancet. In Britain, one in ten young people aged between 5 and 19 is obese. Worryingly, the prevalence of obesity is actually higher in younger children than older ones.

The WHO first called for obesity to be understood as a disease in 1948, but back then it wasn’t even considered a risk factor for cardiovascular disease. In 1997 the WHO held a special conference on obesity and stated that: “the global epidemic projections for the next decade are so serious that public health action is urgently required.”

Then it was alarmed that the prevalence of men with a BMI greater than 30 was 15% and 16.5% in women. To think that it has now risen dramatically to 67% for men and 57% for women, highlights just how serious a problem obesity poses to society.

The calls for more countries to officially recognise it as a disease is based on the position that obesity meets the definition of a chronic, relapsing, progressive disease that causes organ damage.

Women and men who are obese are 12.5 and 5.2 times (respectively) more likely to develop diabetes than people who are a healthy weight. 90% of people with Type 2 diabetes are obese.

People with diabetes are then at a greater risk of a range of chronic health conditions including cardiovascular disease, blindness, amputation, kidney disease and depression than people without diabetes. Diabetes leads to a two-fold excess risk for cardiovascular disease, and diabetic retinopathy is the leading cause of preventable sight loss among people of working age in England and Wales.  About one in twenty people have diabetes, yet people with diabetes account for one quarter to one third of hospital admissions for cardiovascular disease.

According to Government figures released this year, people who have Type 2 diabetes are 28.4% more likely to die early than their peers.

Getting in front of this wave of diabetes will not only bring down the numbers of people affected but also see a positive impact on the numbers of obese people. As with all conditions – the earlier they are identified, the better. To do this, new methods of diagnosis are being developed.

A radical new test for a protein found in our blood called adiponectin can identify pre-diabetes. This is a game-changing diagnostic tool that empowers people with the knowledge that they are at risk, but may be able to avoid it through relatively simple lifestyle changes.

The adiponectin test is available from Randox – both for clinical use and also through our Randox Health clinics.  We have developed the most comprehensive health checks available on the market. These are so sensitive that in a range of conditions including diabetes we are able to identify signs of pre-illness.  This enables clients to make often simple changes to stay healthy.

We know that prevention works. The NHS carried out a study in 2016 which revealed an average 26% reduction in new cases of Type 2 diabetes in those participating in a diabetes prevention programme, compared with usual care.

 

To find out more, click here.

For further information please email: randoxpr@randox.com


Sharing our preventive health message this World Diabetes Day

One of the fastest growing health threats of our times is diabetes. Type-2 diabetes is now among the most common long-term health conditions affecting people right across the globe. On World Diabetes Day we want to raise awareness of this particular condition – because it’s possible to spot warning signs and take steps to prevent it.

THE BACKGROUND

Since 1996, the number of people living with diabetes has more than doubled and type-2 diabetes is by far its most prevalent form. Though it is potentially reversible, using more advanced diagnostics, clinicians can diagnose pre-diabetes and enable patients to make lifestyle changes to avoid the condition from developing in the first place.

THE FUTURE

Adiponectin is a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). This biomarker can be tested as an automated biochemistry reagent from Randox.

With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Randox Adiponectin will enable physicians and clinicians to accurately evaluate more individuals, with a convenient format for routine clinical use.

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to lower T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome. This indicates that Randox automated adiponectin should be a routinely run test across the world.

OUR CASE STUDY – SIR AP MCCOY

Earlier this year Sir AP McCoy came to Randox Health. After a career dedicated to becoming the world’s most successful jockey, he was never going to leave the next stage of his life to chance. It was lucky he did: our advanced test for adiponectin was within the panel of tests run and  was able to identify that AP was pre-diabetic.

Don’t leave your health to chance. 70% of cases of type-2 diabetes are preventable by adopting a number of lifestyle changes, so take action today.

For further information phone the Randox PR Team on 028 9442 2413, or email randoxpr@randox.com 


Randox showcases future-proofing diagnostic technology at MEDICA 2017

Randox Laboratories, the world-leading medical diagnostics manufacturer, is showcasing advancements in laboratory technology at the 2017 MEDICA – World Conference for Medicine conference, being held November 13-16 in Dusseldorf, Germany.

Unveiling its state-of-the-art interactive exhibition stand, Randox will host a series of demonstrations of its innovative analysers including the Evidence Evolution and Rx modena, and a number of exciting advances in laboratory medicine, involving  increasing the test menu available to clinicians and improving the connectivity of laboratories across the world to improve overall quality.

“Through our advancements in laboratory innovation, we’re driving an industry-wide evolution” said Randox CEO, Dr Peter FitzGerald.

“Our products are leading the way in innovation and enabling laboratories to transform the way they operate. We will be hosting demonstrations of a wide range of our fully-automated analysers, which are packed with cutting-edge technology and intuitive software. The goal is to provide future-proof diagnostic technology that will create the most efficient and effective laboratories.”

Paving the way is Randox’s patented Biochip Array Technology (BAT). This multi-analyte testing platform is the product of a £250 million research and development project. The ceramic tile measuring 9×9 mm can currently run up to 49 assays simultaneously,100 assays in the near future.   This innovation allows the simultaneous quantitative or qualitative detection from a wide range of analytes from a single sample. It is suitable for use in a wide range of laboratories including clinical, research, hospital, veterinary and forensic and clinical toxicology.

To enhance the benefits of BAT, Randox introduced the Evidence Evolution to its stable of immunoassay analyser platforms. The Evidence Evolution is the world’s first fully automated random-access biochip testing platform, capable of delivering 2640 results in one hour, with the first delivered in just 37 minutes.

Joining the Evolution in Hall 3 stand A08 is the RX modena. This highly reliable, precise, fully automated clinical chemistry analyser can run 1200 tests per hour including ISE. When combined with its unrivalled RX series test menu, it offers a winning combination for all large, multi-disciplinary laboratories.

“We develop more new tests than any other diagnostics manufacturer, and one of the products that we’re showcasing at this year’s MEDICA is Adiponectin,” added Susan Hammond, Global Sales Manager at Randox.

“This novel biomarker is a powerful new weapon in the fight against some of the biggest health issues faced throughout the world including diabetes, cancers and cardiovascular disease. As it’s World Diabetes Day on Tuesday 14th November, it’s a great opportunity to draw attention to this array which labs can run as part of their routine testing panel.”

MEDICA attendees will also be among the first to experience the advancements delivered by the latest update for Randox’s Acusera 24.7. This online interlaboratory data management and peer reporting package is now smarter, faster and more powerful than ever before.

Acusera 24.7 is designed to help laboratories efficiently review QC data from all their lab instruments on one central platform, thereby allowing quick and easy identification of QC failures and emerging trends. Unique access to peer group data updated instantly in real-time from our global network of laboratory participants will speed up troubleshooting and help pinpoint the root cause of any QC failures by easily identifying if an issue is isolated or widespread.

 

The Randox team will be on hand throughout MEDICA 2017 at stand #3A08. To make an appointment in advance, contact them through the Randox MEDICA webpage.

Click here for more information on Randox, or to get in touch, phone the Randox PR Team on 028 9442 2413, or email randoxpr@randox.com 


Measuring T2DM Risk with Randox Automated Adiponectin

During the first week of our adiponectin educational month, we focused on different aspects of our free white paper “Early Risk Assessment of Type 2 Diabetes Mellitus Through the use of the Biomarker Adiponectin”, which details the features and benefits of Randox automated Adiponectin, clinical significance and a comparison to traditional methods for diabetes risk assessment.

Randox Adiponectin is an automated biochemistry reagent, used as a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Offering an improved method for assessing risk, with a convenient format for routine clinical use, Randox Adiponectin will enable physicians to accurately evaluate more individuals.

Read on to find out more!

Monday 11th September

Traditional Methods for Diabetes Risk Assessment

Randox adiponectin offers a more improved, automated method for assessing Type 2 Diabetes Mellitus (T2DM) risk compared to traditional methods of diabetes risk assessment. Such methods include:

  • Fasting Plasma Glucose (FPG) – This is the most commonly used biochemical method of assessing T2DM, however, the specificity of this test is poor. Although many individuals are identified as having impaired fasting glucose (IFG), their absolute risk of conversion to diabetes is only 5-10% per year.
  • Oral Glucose Tolerance Test (OGTT) – This method is more accurate for risk assessment than other traditional methods, however, it is rarely used in practice as it is takes two hours to perform and is uncomfortable for patients.

Non-biochemical methods for assessing a patient’s risk of developing T2DM take into consideration gender, age, family history of T2DM, BMI, waist size and high blood pressure to give a risk score. Two of the most popular, traditional indicators include:

  • Waist circumference – measures abdominal fat reliably, but its association with visceral fat varies by gender and ethnicity.
  • Body Mass Index (BMI) – is another common method, however it has limitations in measuring athletes and varies depending on age, sex and race.

Given the limitations of OGTT and FPG, an improved method for assessing T2DM risk, with a convenient format for routine clinical use, would enable physicians to accurately evaluate more individuals. Randox adiponectin is an automated biochemistry test utilising a latex enhanced immunoturbidimetric method which removes the inconvenience and time consumption associated with traditional methods of testing, making it a superior method of testing T2DM.

 

Tuesday 12th September

Clinical Significance

Recent studies have advocated the testing of adiponectin in clinical settings. It has applications in assessing risk in several diabetes-related conditions including prediabetes, T2DM and GDM. These studies include:

BMJ (2016): Adiponectin levels predict prediabetes risk: the Pathobiology of Prediabetes in A Biracial Cohort

This study found that among health white and black adults with parental history of T2DM, adiponectin level is a powerful risk marker of incident prediabetes. Thus, the association of adiponectin with diabetes risk is evident at a much earlier stage in pathogenesis, during transition from normoglycemia to prediabetes.

Diabetes Care (2013): Low Pre-pregnancy Adiponectin Concentrations Are Associated With a Marked Increase in Risk for Development of Gestational Diabetes mellitus

This was a study carried out on 4098 women who had children within 6 years of initial blood sample and none of whom were pre-diabetic or diabetic. It was found that lower adiponectin concentration measured on average 6 years before pregnancy were associated with a 5-fold increased risk of developing GDM.

 

Implications for Clinicians

Adiponectin measurement is not yet a routinely run test in many laboratories worldwide and it is therefore not available for many clinicians to request. Yet the implications of this becoming widely available could be extremely valuable as it can help to assess:

  • Type 2 Diabetes Mellitus and Incident prediabetes
  • Cardiovascular events
  • Gestational Diabetes

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to reduce visceral fat levels and lowering T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome through the improvement of adiponectin production. This indicates that Randox automated adiponectin should be a routinely run test across the world.

13th September 2017

Methods of Measuring Adiponectin

Randox adiponectin automated method has many benefits for the laboratory, as the only method of adiponectin measurement available beforehand was through the ELISA assay. The benefits of switching from ELISA to an automated method include efficiencies and expansion.

Efficiencies

The main drawback of using ELISAs for clinical testing within a laboratory is that it is time consuming and personnel consuming as it uses heavy resources with manual interaction. Switching from ELISA to an automated method for the detection of adiponectin increases time and personnel efficiency considerably which leads to cost effectiveness. This benefits laboratories through:

  • Ensuring quality in testing practices and confidence in clinical results
  • Lowering the risk of error and contamination avoiding compromising clinical results

 

Expansion

Laboratories can expand their test offerings to patients and clinicians by transitioning analytes which were historically only available on ELISA methods. Adiponectin being available in an automated biochemistry format allows laboratories to expand their test menu with ease and enables the inclusion of adiponectin into routine testing panels. It also allows for detailed patient testing profiles through increased testing range and without the manual restrictions placed by running ELISA techniques.

Randox is presently the only diagnostic manufacturer who has a globally available automated biochemistry test for adiponectin measurement.

14th September 2017

Randox Automated Adiponectin Assay

The Randox adiponectin assay principle:

  • The sample is reacted with a buffer and anti-adiponectin coated latex
  • The formation of the antibody-antigen complex during the reaction results in an increase in turbidity – this is measured as the amount of light absorbed at 570nm.
  • A sample with higher adiponectin levels will contain more adiponectin and so more antibody-antigen complexes will be formed and the increase in turbidimetry
  • By constructing a standard curve from the absorbance of the standards, the adiponectin concentration of the sample can be determined.

Benefits of Randox adiponectin:

  • A niche product meaning we are one of the only manufacturers to provide the adiponectin test in an automated biochemistry format
  • Automated assay removing inconvenience and time consumption associated with traditional ELISA testing
  • Applications available for a wide range of automated biochemistry analysers ensuring ease of programming and confidence in results
  • Latex Enhanced Immunoturbidimetric method delivering high performance
  • Extensive measuring range for measurement of clinically important results
  • Complementary controls and calibrators available offering a complete testing package

The Randox automated immunoturbidimetric adiponectin test offers an improved method for assessing T2DM risk, with a convenient format for routine clinical use, to enable physicians to accurately evaluate at-risk individuals.

Please contact us at reagents@randox.com for more information!

Download our white paper from the resource hub.


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