The use of Glycosylated Hemoglobin (A1C) in Diagnosing Diabetes (Essay Sample)

The use of Glycosylated Hemoglobin (A1C) in Diagnosing Diabetes
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The use of Glycosylated Hemoglobin (A1C) in Diagnosing Diabetes
Overview of the Article
Line Damsgaard and Michael Pedersen have taken a critical discussion of glycosylated hemoglobin (A1C) as a diagnostic tool for diabetes mellitus. In their article titled Use of Glycosylated Hemoglobin as a Diagnostic Tool in Greenland: Prevalence of Diagnosed Diabetes Mellitus, (/content/5/1/59) the authors take a closer look at the role played by A1C in the diagnosis of diabetes mellitus. Although the new diagnostic tool is ideal for determining the presence of diabetes, the use of blood glucose testing should not be ignored as A1C has its limitations.
Background
The frequency of undiagnosed diabetes is estimated to be 30 percent. In 2010, a new diagnosis tool referred to as glycosylated hemoglobin (A1C) was formulated to help in the diagnosis of diabetes mellitus in Greenland. The current use of A1C as a diagnostic tool for diabetes has been the subject of discussion. The article under review explores the use of A1C as a diagnostic tool two years since its introduction.
Introduction
Greenland has experienced a quick transformation during the last fifty years. A half century ago, Greenland was a small conventional society that was comprised of only small communities, but today it is a modern society. The period spanning from 1950-1970 saw this society transform from hunting to begin relying on wages (Jorgensen, et al, 2012). The far-reaching social and cultural transformation brought about a health transition with a rising frequency of lifestyle diseases. Some of these diseases were obesity, diabetes and heart diseases just like in other Canadian cities (Damsgaard, & Pedersen, 2013).
Before this lifestyle transformation, only less than 1 percent of the Greenland population used to be diabetic. However, research shows that there is a high prevalence of diabetes in Greenland with estimates showing that about 10 percent of the population is diabetic. The main mode of diagnosis that was used to arrive at these conclusions was the oral glucose tolerance tests (Curtis, Kvernmo, & Bjerregaard, 2005). However, about 70 percent of the cases remained undiagnosed thus denoting a low indicative activity.
In 2008, the authorities embarked on a diabetes sensitization and awareness program on the island. Within two years after the commencement of this campaign, the prevalence rate of type 2 diabetes mellitus (T2DM) in Greenland went up by almost 20 percent. However, the frequency of diagnosed T2DM was still way below what was indicated in the community. As a way of bettering the diagnostic procedure of diabetes and also ensuring that the case finding remained more viable in the island, the diagnosis approach was altered in mid-2010. From then henceforth, glycosylated hemoglobin (A1C) was formulated to be the screening tool in the region, taking the place of the earlier utilization of fasting blood sugar. However, the diagnostic activity of A1C has not been explored since its inception (Jorgensen, et al., 2012).
Study Population
In order to complete the research, the study sampled the entire population of people that were above the age of 35 years. This cutoff was introduced since a high number of individuals with this type of diabetes are above the age of 35 years. The number of people who had been diagnosed with diabetes after the introduction of the A1C kit in 2010 was excluded from the study.
Use of A1C as a Diagnostic Kit
The utilization of A1C as a diagnostic kit within two years after its introduction inspires its use in Greenland. Unlike fasting blood sugar or the oral tolerance test, A1C is ideal as it does not require any special preparation. The A1C tests vary significantly from those done using plasma glucose (Curtis, Kvernmo, & Bjerregaard, 2005). From this research, there is also sufficient evidence that ethical differences pose challenges when using the hemoglobin A1C. This problem means that a smaller percentage of the population is diagnosed when using the A1C toolkit than when making diagnosis using the oral glucose test. This challenge was evident in Greenland where the previous glucose test had yielded a 7.0 percentage rate while the A1C toolkit had only a 3.9 percent turnover rate. In addition to this, the prevalence rate for diabetes using the oral glucose test in the United Kingdom was higher as compared to the incidence rate using the A1C toolkit (John, 2011).
Despite this, the convenience of using A1C as compared to other forms of diabetes testing has the likelihood of raising the total number of those tested. There is also sufficient evidence that the severest cases are the ones that have been tested using A1C. Utilizing A1C in the test for diabetes unlike in the past where blood capillary was used is also ideal as it complies with the international guidelines for the diagnosis of diabetes.
Although AIC has some shortcomings, it is still the most recommended tool in the process of diagnosis of diabetes because it is efficient. In essence, the glycated hemoglobin gets produced by the non-enzymatic glycation of hemoglobin I in the human body. This form of testing is recommended as it measures chronic glycaemia instead of the instant blood glucose like the other diagnostic kits. Apart from this, the use of this diagnostic toolkit can be used as a pointer to the development of diabetes in the future (Selvin, et al., 2010).
Just like any other diagnostic kit, A1C has its strengths and weaknesses. In the article under review, it was hard to know the actual number of those diagnosed using this new method. Considering th...