Celebrating World Diabetes Day 2022!
Celebrating World Diabetes Day, 14th November 2022!
Diabetes is a serious medical condition that causes blood glucose (sugar) levels to become too high. This can cause complications such as heart disease, stroke, kidney problems or nerve damage if not treated.
Although there is no cure for Diabetes, the condition can be controlled and monitored.
There are three main types of diabetes, type one, type two and gestational diabetes. The former two are lifelong and can cause life threatening complications if not monitored effectively.
Type one diabetes is when the body can’t make insulin, which is thought to be caused by an autoimmune reaction. In the UK, around 8% of the population have type one.
Type two diabetes is generally caused from lifestyle, when the pancreas doesn’t work properly and can’t keep your blood sugar levels from rising. Type two represents around 90% of people with diabetes in the UK.
Gestational diabetes Mellitus (GDM) is a form of diabetes that appears in pregnancy, characterised by high blood sugar due to the hormones produced in pregnancy. In the UK, around 5% of pregnant women are diagnosed every year.
Globally, Diabetes affects more than 415 million people, with type 2 being the most common.
People with T1D have an estimated 50% risk of developing Chronic Kidney Disease over their lifetime. CKD can progress to kidney failure, requiring dialysis or a kidney transplant. Taking a personalized approach to kidney disease screening for people with type 1 diabetes (T1D) may reduce the time that chronic kidney disease (CKD) goes undetected, according to a new analysis performed by the Epidemiology of Diabetes Interventions and Complications study group.
World Diabetes Day aims to increase visibility around the condition and can help sufferers feel less alone. Charities such as Diabetes UK also use the day to help promote awareness and information around the condition to help get people diagnosed earlier through campaigns such as #RewriteTheStory.
Randox reagents cover a spectrum of laboratory testing which can help monitor Diabetes and the effectiveness of management. This can help prevent serious complications which can become life threatening.
Diagnosis and Monitoring
Fructosamine (Glycated Protein) has been identified as an early indicator of diabetic control compared to other markers such as HbA1c. HbA1c represents the average blood glucose levels for the previous 2-3 months, conversely fructosamine reflects average blood glucose levels of the previous 2-3 weeks. HbA1c levels may also be impacted by genetic, haematological and disease-related factors. The enzymatic Fructosamine method also offers improved specificity and reliability compared to conventional NBT-based methods and does not suffer from non-specific interferences unlike other commercially available Fructosamine assays.
Complications Monitoring – Ketoacidosis
D-3-Hydroxybutyrate (Ranbut) is the most sensitive ketone for the diagnosis of ketosis, in particular diabetic ketoacidosis (DKA) , because it represents approximately 80% of ketones present in blood during DKA. The nitroprusside method commonly used in semi-quantitative dipstick tests only detects acetone and acetoacetate making it less accurate.
Complications Monitoring – Renal Dysfunction
Cystatin C is extremely sensitive to very small changes in GFR and has been identified as a strong predictor of clinical outcomes associated with chronic kidney disease (CKD). Cystatin C doesn’t have a ‘blind area’ like creatinine. Up to 50% of renal function may be lost before significant creatinine elevation occurs. NICE guidelines recommend cystatin C testing due to its higher specificity for significant disease outcomes.
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Diabetes is a life-long condition causing blood sugar levels to become too high and affects millions of people worldwide. Whilst the condition cannot be cured, it can be controlled and monitored. Randox diabetes reagents cover a spectrum of laboratory testing requirements from disease diagnosis to monitoring of associated complications.
The 3 Types of Diabetes
Type 1 diabetes manifests in childhood and is caused by deficiency (inherited or acquired) in the production of insulin by the pancreas and so the daily monitoring and administration of insulin is required.
Type 2 diabetes manifests later in life and occurs when the body produces insulin but does not use it effectively (known as insulin resistance). It is more common than type 1 diabetes, and is usually caused as a result of excess body fat and lack of physical activity. Type 2 diabetes can occur in any individual regardless of weight. Excess abdominal visceral fat has also been correlated with increased risk of type 2 diabetes. Visceral fat is the fat that surrounds the vital organs in our bodies. High levels of visceral fat is common on those who have a high BMI, however those with a healthy BMI but do not eat a healthy diet or exercise also can have high levels of visceral fat. Additionally, heart disease, hypertension, stroke and some cancers has also been linked to type 2 diabetes.
Gestational diabetes is the development of diabetes during pregnancy as a result of the body being unable to produce enough insulin to meet the extra needs during pregnancy. Gestational diabetes can cause problems for both the mother and baby during and after birth, including: polyhydramnios, pre-eclampsia, the baby developing jaundice or low blood sugar levels after birth, or stillbirth. However it is possible to reduce the chances of these risks occurring if gestational diabetes is diagnosed and consistently monitored.
Diagnosis and Monitoring
Routine tests are carried out in conjunction with diabetes testing include;
- Microalbumin to ensure normal kidney function and Albumin to ensure normal liver function.
- Glucose is a major source of energy for most cells in the body and obtained through carbohydrate enriched foods. Insulin helps control blood glucose levels to ensure they do not get too high, and as such, high levels of glucose in the blood is an indicator of diabetes.
- HbA1c is used to identify the average amount of glucose in the blood over a 2-3-month period. It is a good indicator of diabetes, as well as enabling diabetic patients to understand how well their diabetes is being controlled.
- Fructosamine is used in the monitoring of diabetes and is particularly useful in reviewing the effectiveness of medication adjustments. This is because it enables average glucose levels to be obtained over a 2-3 week period. In addition, it is used to monitor glucose levels of pregnant woman suffering from gestational diabetes which allows for the monitoring of both, mother and baby glucose levels. This is crucial in decreasing risks associated with gestational diabetes such as premature birth, immediate infant health problems, miscarriage or stillbirth.
Complications Monitoring – Speciality Tests
The Randox specialist tests include;
- Cystatin C is a more sensitive indicator of renal dysfunction than routine creatinine due to the creatinine blind range. Also, the elevated creatinine levels found in stage 2 and halfway through stage 3 renal dysfunction cannot be detected. Therefore, patients can suffer from 50% of kidney dysfunction before elevated levels are detected. Using the Cystatin C test enables more accurate patient results, and allows time for treatment to begin before it is too late.
- Beta-2 Microglobulin is used when kidney damage has occurred to distinguish between the two most commonly affected sites, glomeruli and renal tubules.
- D-3-Hydroxybutyrate is used in the identification of diabetic ketoacidosis, a serious complication of diabetes which occurs when blood sugar levels are consistently high and insulin levels are severely low. Immediate diagnosis is vital as the condition can lead to coma or death if not treated immediately. Symptoms include nausea, vomiting and abdominal pain
- Non-Esterified Fatty Acids (NEFA) is linked to an increased risk of developing diabetes. The measurement of NEFA is important in cases where insulin deficiency results in the metabolism of fat. An increase in NEFA concentration has also been associated with adiposity (high level of body fat), malignant disease (progressive disease) and other metabolic syndromes such as high blood pressure and abdominal obesity. Non-Esterified Fatty Acids (NEFA) to assess diabetic patients risk of developing adiposity (high level of body fat), malignant disease (progressive disease) and other metabolic syndromes such as high blood pressure and abdominal obesity (NEFA test is important in cases where insulin deficiency results in the metabolism of fat).
Related biomarkers include:
Many health complications associated with diabetes include; kidney disease, eye disease, cardiovascular disease and diabetic ketoacidosis (a life-threatening condition that can develop in insulin dependent diabetics). Therefore, it is important to control and monitor the condition.
- Cystatin C is a sensitive marker of kidney function used for the detection of early renal dysfunction in diabetic patients. It is important to note that creatinine is the routine test for renal dysfunction, however it has a blind range which means it is unable to detect elevated creatinine levels found in stage 2 and halfway through stage 3 renal dysfunction. As a result of this, 50% of kidney function can be lost before elevated creatinine levels are detectable. The cystatin C test is a more sensitive marker and can detect early stages of renal dysfunction, allowing treatment to begin before it is too late.
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.
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