Diabetes Testing: How Can Labs Prepare for Post-pandemic

Lack of routine testing on diabetes management and prevention are among the current pandemic-related challenges laboratories are facing. Read more about how laboratories can prepare for life after COVID-19.
Diabetes Testing: How Can Labs Prepare for Post-pandemic

Why is Early Detection of Diabetes Important?

Figure 1i

Currently, the number of individuals with diabetes is on the rise – and it’s on track to increase (Figure 1). Though the numbers are rising, the International Diabetes Federation estimates that in 2019, half of the individuals living with diabetes (232 million people) did not know they had it.ii

The starting point for living well with diabetes is an early diagnosis – the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be.
World Health Organization
Global Report on Diabetes iii

The Impact of COVID-19 on Individuals with Diabetes

The coronavirus pandemic has increased the mental and physical burdens for individuals with underlying health conditions, such as diabetes. As a result of COVID-19, routine doctor visits were converted to telemedicine, and outings to have routine tests, such as getting blood drawn, became risks for exposure.iv Due to this, routine lab testing volumes have plummeted by approximately 60% as patients put off carev, while COVID-19 has increased lab testing demands by nearly 25 percent.vi

People with diabetes have a high risk of becoming seriously ill when infected with SARS-CoV-2. Not being able to get HbA1c levels tested has an adverse impact on patients with diabetes, where regular HbA1c testing is needed to control glucose levels and prevent diabetes complications. Also, well-controlled glucose levels may prevent severe cases of COVID-19.vii

Routine Testing During COVID-19

According to the CDC, an estimated 41% of U.S. adults had delayed or avoided medical care, including urgent or emergency care (12%) and routine care (32%) by the end of June 2020viii (Figure 1).

Delaying or avoiding needed medical care likely increases morbidity and mortality associated with chronic and acute health conditions, including patients who have type 2 diabetes or are pre-diabetic who benefit from HbA1c testing, one of the most robust tests we have to assess, diagnose and manage diabetes.ix Lack of testing for diabetes is also detrimental for COVID-19 outcomes for patients who have diabetes. Screening asymptomatic patients to detect prediabetes and initiate lifestyle changes has the added benefit of reducing the risk of adverse events if a person gets COVID-19.x

Get Automated. Get Ready.

As the pandemic rages and testing volumes increase, laboratories have an opportunity to deliver high-quality results more cost-effectively and efficiently with automation, which can help to address staff shortages while enabling resources to focus on high-value clinical tasks. There is strong evidence that an efficient Total Lab Automation model can successfully lower laboratory diagnostics costs while decreasing congestion in laboratories and improving efficiencyxi  — which is exactly what labs of all sizes will need after the pandemic to deal with the increase in testing volumes. Laboratories are continually striving for shorter TAT and less instrument downtime. This is why laboratories need to dust off the instruments and the backup instruments that may not have been in use during the pandemic and ensure that they are in mint condition — with completed validation and quality control.

For three ways your laboratory can prepare to be strong enough post-pandemic, check out our recent feature on Medical Laboratory Observer (MLO).

Diagnostic Diabetes Testing from A(1c) to Z

An A1c test is the marker used to help diagnose diabetes mellitus, monitor long-term glucose control in individuals with diabetes mellitus and identify patients who may be at risk of developing diabetes mellitus.

In fact, measuring HbA1c every two to three months serves as the accepted standard for glycemic control in the care and treatment of patients with diabetes mellitus. The American Diabetes Association recommends using a Hemoglobin A1c (HbA1c) method certified by the International Expert Committee (IEC)xii, the National Glycohemoglobin Standardization Program-certified (NGSP).xiii  It is standardized by the Diabetes Control and Complications Trial (DCCT).xiv The following organizations recommend using Hemoglobin A1C (HbA1c) method.xv, xvi

Beckman Coulter offers a comprehensive menu with high medical value to aid with diagnosis and continuous monitoring of diabetes and enhance patient care.

  1. Worldwide toll of diabetes. (2019). International Diabetes Federation. https://diabetesatlas.org/en/sections/worldwide-toll-of-diabetes.html
  2. About Diabetes: Facts & figures. (2020, December 2). International Diabetes Federation. https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html
  3. Global report on diabetes. (2016). World Health Organization. https://www.who.int/publications/i/item/9789241565257/
  4. John A. "Coronavirus offers new challenges to people trying to manage diabetes and kidney disease." May 11, 2020. Los Angeles Times. https://www.latimes.com/science/story/2020-05-11/underlying-health-conditions-diabetes-coronavirus-challenges [Accessed: January 28, 2021]
  5. https://www.xifin.com/news/press-releases/2020/new-xifin-data-reveals-routine-lab-volume-down-approximately-60-coronavirus [Accessed: January 28, 2021]
  6. Silva, B. "The impact of COVID-19 on Molecular Diagnostics." MLO. Oct 22, 2020.
  7. Lim, S., Bae, J.H., Kwon, HS. et al. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol 17, 11–30 (2021). https://doi.org/10.1038/s41574-020-00435-4
  8. Czeisler MÉ, Marynak K, Clarke KE, et al. Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1250–1257. DOI: http://dx.doi.org/10.15585/mmwr.mm6936a4.
  9. Lau CS, Aw TC. "HbA1c in the diagnosis and management of diabetes mellitus: an update." OAT. January 6, 2020. DOI: 10.15761/DU.1000137.
  10. Wagner M & Lohmann T. "Hyperglycemia associated with hospitalization for severe COVID-19 infection." MLO. October 22, 2020. https://www.mlo-online.com/continuing-education/article/21158867/hyperglycemia-associated-with-hospitalization-for-severe-covid19-infection [Accessed: January 28, 2021]
  11. Lippi, G., & Da Rin, G. (2019). Advantages and limitations of total laboratory automation: a personal overview, Clinical Chemistry and Laboratory Medicine (CCLM), 57(6), 802-811. doi: https://doi.org/10.1515/cclm-2018-1323
  12. International Expert Committee, 2009. International Expert Committee report on the Role of the A1C assay in the Diagnosis of Diabetes. Diabetes Care, 32(7), pp. 1327-1334.
  13. NGSP: HbA1c Assay Interferences. (2020, August). NGSP. http://www.ngsp.org/interf.asp
  14. Diabetes Care 2018: 41 (Supplement 1): S13-S27. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes, 2018.
  15. The WHO Logo and Emblem. (2021). World Health Organization. https://www.who.int/about/who-we-are/publishing-policies/logo
  16. Home | ADA. (2021). American Diabetes Association (ADA). https://www.diabetes.org/
Editorial Team
Editorial Team
The Beckman Coulter editorial team brings you timely news and resources focused on elevating clinical laboratory performance and advancing patient care.

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