On Thu, 23 Feb 2006 12:45:55 -0600, OmManiPadmeOmelet
> wrote:

>In article >,
> Boron Elgar > wrote:
>
>> On Thu, 16 Feb 2006 15:00:45 -0600, OmManiPadmeOmelet
>> > wrote:
>>
>>
>> >Be sure to get a hemoglobin A1C
>>
>> Unless there is some reason to run an HBA1c, it will not be done.
>>
>> IIRC, you work in a lab, so you know that fasting BG is part of the
>> usual blood work conducted for routine exams. Unless the fasting BG or
>> a GTT is unusual or something else is suspected or being monitored for
>> some reason, they wouldn't even be able to code it to get an insurance
>> company to pay for an HBA1c.
>>
>> Me? I get one every 3 months, but I am a diabetic. (Always below 6.0
>> for me)
>>
>> Boron
>
>Fortunately, that test is being ordered more frequently now as a
>SCREENING test for type II diabetes early onset as it's more indicative
>than a fasting glucose. If you can catch that condition in time, it can
>be corrected with diet (and Metformin) before it does irreversible
>damage...

Insulin resistance shows up in fasting BGs, too, if they are tracked
over time or repeated if out of range.....and unless there are some
other risk factors involved, some indication of metabolic syndrome,
the HBA1c is an unusual test to order. There has to be some reason
for it. It is not part of a "normal" screen. It just isn't and I have
seen no guidelines that suggest it should be.

>Insulin resistance with obesity is becoming more and more common
>nowadays and often indicates a good chance of becoming a type II
>diabetic.

But just being obese will not trigger any protocol for including an
HBA1c . I mean, it'd be swell and all, but unless something else shows
in the blood work, or other risk factors are involved, it is an
expensive test to use as a common screen and no medical source I have
seen recommends that it be used that way.

I had a real porky mama whose blood sugar was normal her whole life. I
had a skinny dad who developed diabetes in his 40s (along with a lot
of other skinniest on his side of the family). Go figure.

>A glucose tolerance test is not a bad thing, but it's kinda being phased
>out now except for pre-natal workups.

Quite true, but you'd be surprised at what some docs will order. AND
there are a lot of docs who will work with a patient to make sure that
they are treated for any developing insulin resistance in order to
prevent a diagnosis of diabetes being on the records. Once a diagnosis
like that is made, all hell can break loose with health insurance,
life insurance, etc. Even ordering an HBA1C can raise eyebrows at an
insurance company. Again, it has to be coded to be done and that means
some reason needs to be found to do it.

Boron