Study advocates use of low-cost diabetes screening test for hospitalised patients
Testing glycated haemoglobin (HbA1c) levels using blood samples taken from all adult patients admitted to hospital is a simple and inexpensive method to screen hospitalised patients for diabetes, according to research published in the latest Medical Journal of Australia.
Dr Matthew Doogue, an endocrinologist at the Southern Adelaide Diabetes and Endocrine Service, and co-authors, including lead author Dr Nyoli Valentine, conducted a three-month prospective study of all adult patients admitted to a tertiary hospital.
An HbA1c test was automatically undertaken on admission for all patients with a random plasma glucose level of 5.5 mmol/L and higher, using blood samples drawn during usual clinical care.
The researchers found that the prevalence of undiagnosed diabetes was 11 per cent, about three times that in the adult Australian population.
In this study, the HbA1c test cost $152 per new diagnosis of diabetes. The researchers estimated that the ongoing cost of using HbA1C to test hospitalised patients would be about $2100 per new diagnosis of diabetes.
“Based on our findings, we believe the most practical approach to screening hospitalised patients for diabetes is to test HbA1c in all adult patients having blood tests on admission,” Dr Doogue said.
“Automated HbA1c testing was easily implemented using existing blood samples and was an inexpensive method to diagnose diabetes in this patient cohort.”
Dr Doogue said that 17 per cent of patients with previously unknown diabetes in the study did not identify having a regular GP, highlighting the value of using hospitalisation as a point of contact with the health system to screen patients who would otherwise be missed.
He said that a hospital inpatient diagnosis of diabetes was only useful if patients received adequate long-term management.
“If adopted as a screening tool, would need to be coupled with adequate resources for follow-up and management of diabetes in the community,” he said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACT: Mr Ross Verschoor 08 8204 4949
Manager, Media & Communications
Southern Area Health Service
Flinders Medical Centre Media Office
