There are significant health complications that come with diabetes, such as micro vascular damage which can impact the brain, feet and eyes, and macro vascular damage that can seriously impact organs like kidneys and the heart.

In addition to that there are substantial healthcare costs that governments need to consider. In Australia, direct costs are $1.7bn a year, the indirect costs, $14bn.

Avoiding these complications is therefore an absolute health and economic imperative.

According to a report from the Centre for International Economics, detecting diabetes at its early stages can halve medical costs and significantly improve health outcomes.

And if you can pick up on your risk at the prediabetes stage, the opportunity to turn your health around without significant medical complications is significantly enhanced.

So what’s the test and who should take it?

There are two ways to test for diabetes, the measurement of blood sugar levels or the HbA1c test. The HbA1c test is simpler and does not require fasting and unless your doctor finds a reason that the test is not suitable for you it can be used. The HbA1c test takes a snapshot of your blood sugar levels over the last three months.

If you haven’t had an HbA1c diabetes test before, you should speak to your doctor about it if the following apply to you: if you’re over 35 years of age, your waist is over 100cm, you have a family history of type 2 diabetes, blurred vision, are thirsty, or do less than two-and-a-half hours of exercise a week.

The healthy range for HbA1c is less than 6.0% (also expressed as less than 41 mmol/mol)  and results of 6.5% (48 mmol/mol) or higher indicates diabetes. Results from 6.1% to 6.4% indicate a higher risk of developing diabetes in the future.

How often should you take the test?

How often you should take an HbA1c test to monitor your glycated haemoglobin levels depends on what category you fell into in the first test, as well as ongoing lifestyle choices which we will be looking at in a future article.

Ideal range

If you scored a range of 6.0% or lower in your test, that’s a good thing and you’re clearly doing something right.

‘A person who has an HbA1c 6.0% or lower is in the expected range for a healthy person and is showing good glucose control,’ says Associate Professor Graham Jones, an Australian Clinical Biochemist and pathologist.

‘That being said, there are several other health factors that impact risk, so you need to keep an eye on those things. Your GP is best to advise you here, but as a rule of thumb it’s worth having the discussion with your doctor every three years.’

Prediabetes range

An HbA1c from 6.1% to 6.4% places you in the “at risk” range. That’s not ideal, but the good news is that you have the opportunity to institute lifestyle changes which can help you avoid progressing to diabetes and the serious medical conditions flowing from diabetes.

‘The thing about prediabetes is that it’s an opportunity to do a stocktake of your lifestyle and make changes before serious medical complications begin,’ says Professor Jones.

‘In terms of how often someone in this range should have an HbA1c test, a repeat test in a year is usually recommended, although it should be noted that Medicare does not cover more than one test per year without a diagnosis of diabetes.’

Diabetes range

If you have scored 6.5% or above on your HbA1c test, you are in the diabetic range and will need to speak to your doctor about how to manage the condition to avoid further health complications. The first step will be a repeat test to confirm the diagnosis.

Your doctor will identify the correct HbA1c “target” for you with lifestyle factors being the first line on therapy, but often medications are also needed to keep the HbA1c at the desired level.

‘People who have been diagnosed with diabetes need to have an A1c test every three months initially to make sure the measures you’re taking to manage the condition are working.

‘If you manage to bring it under control, you might be able to wait longer, but taking a test twice a year would be considered the minimum,’ said Professor Jones.

The post How often should you have a type 2 diabetes test? first appeared on Know Pathology Know Healthcare.

Congratulations, you just had your first pathology test, but certainly not your last. The testing of blood, urine and tissue continues throughout a person’s life-cycle.

And it’s a good thing too. Pathology tests are there to pick up on any health concerns nice and early, when they are at their most treatable.

Whatever stage of life you’re at – from being freshly minted to being longer in the tooth – pathology tests are there to help you monitor the inner workings of your body for optimal health.

We run through five tests everyone is likely to have through their lifetime.

Babies | Heel prick test

‘Hey, I didn’t ask for this!’ This is true, sorry fresh baby, but the heel prick test is very important. Taken 48-72 hours after birth, the heel prick test is looking for several conditions:

• Phenylketonuria (PKU) – a condition in which the liver can’t breakdown the amino acid phenylalanine (a building block of protein) and if left untreated can lead to intellectual disability
• Hypothyroidism – the thyroid helps regulate your metabolism. An underactive thyroid doesn’t produce enough hormones and can significantly impact intellectual development and a baby’s growth
• Cystic fibrosis – this condition leads to the production of too much mucus, which clogs the lungs and pancreas, preventing them from functioning properly
• Medium Chain Acyl CoA Dehydrogenase (MCAD) Deficiency– this condition results in inability of the body to completely break down fat. If untreated, it may be life-threatening during common childhood illnesses
• Congenital Adrenal Hyperplasia-an altered ability of the adrenal gland to produce hormones that may affect the baby’s metabolism, response to infection, ability to regulate salt levels and sex characteristics
• Various metabolic disorders – involving amino acid, organic acid and fatty acid oxidation, these disorders can have serious and even fatal effects if not treated

All ages | Full Blood Examination

The no-frills, all-rounder of the blood testing world, the full blood examination (FBE) or full blood count (FBC) is an exam you might have at various stages and for various reasons:

• Anaemia – a low red blood cell count may indicate anaemia
• Various organ diseases – a high red blood cell count may indicate heart, lung or kidney disease, low numbers of white blood cells may indicate liver or spleen disorders
• Leukaemia – high levels of white blood cells may point to leukaemia
• Eclampsia – a high haematocrit count may indicate eclampsia
• Iron deficiency – smaller sized red blood cells may indicate iron deficiency

Middle-age | HbA1c or type 2 diabetes test

Anyone around middle-age will want to speak to their doctor about whether they should be having this test, with diabetes growing at enormous rates across the world.

If you are over 35, have a waist circumference over 100cms (95 for some ethnic groups), or exercise less than 2.5 hours a week, you will want to seriously consider this test.

A person can go for seven years without showing any symptoms of diabetes, during which time it can be causing serious damage to your kidneys, heart, eyes and extremities.

Later middle age: cholesterol

By the time you’re past the half-way mark of life, there’s a good chance you’ve dispatched your fair share of cheeses, lasagnes and choc-tops and might want to check your cholesterol.

The cholesterol test looks for several types of lipids:

• Low-density lipoprotein (LDL) cholesterol – also known as ‘bad cholesterol’, a high level of LDL cholesterol is linked to heart disease and stroke
• High-density lipoprotein (HDL) cholesterol – this good cholesterol helps clean your arteries from fatty build-ups. High is good.
• Triglycerides – high triglycerides can be a pointer to cardiovascular disease or diabetes.

Older age: urine and stool tests

Examining poo and wee is not just for children and comedians. A lot can be determined about someone’s health by looking at urine and stool samples.

Technically these are two types of tests that we’ve briefly outlined below:

• Urinalysis– like the FBE, a lot can be determined by a urine test, or urinalysis. Conditions which can be picked up through a urine test include urinary tract infections (UTIs), kidney disorders, liver disease, or diabetes.
• Bowel cancer screening – for Australian citizens between the ages of 50 and 74, the federal government sends a free bowel cancer screening test kit for a stool sample to be taken at home. If caught early, 90% of bowel cancer cases can be successfully treated.

Of course, the above list of tests is by no means comprehensive. There are a multitude of pathology tests performed every day to help detect medical conditions and to help monitor the treatment of those who already have medical conditions.

Medical scientist and Pathology Awareness Australia ambassador, David Nielsen explains the importance of pathology testing through the life cycle.

‘A lot of people’s experience with medicine is usually with a doctor at the local GP clinic or at a hospital.

‘But there is a whole world of medical diagnosis going on behind the scenes in pathology labs. Every year there are 500 million tests conducted in Australia,’ said Mr Nielsen.

‘And while pathology accounts for just 3% of the annual healthcare budget, 70% of medical treatment decisions rely on pathology.’

The post From cradle to grave: five pathology tests you will likely have through your life first appeared on Know Pathology Know Healthcare.