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*Only for medical professionals to read for reference.
With the new standards for diabetes diagnosis, it is necessary to grasp the accuracy of detection methods.
The "Chinese Type 2 Diabetes Prevention and Control Guide (2020 Edition)" (hereinafter referred to as "Guide") was officially released in April this year.
Compared with the previous edition, the new "Guide" has updated the main points in many aspects such as the diagnostic criteria, treatment path and blood glucose monitoring and management of type 2 diabetes (T2DM).
Recently, Professor Bian Hua from Zhongshan Hospital Affiliated to Fudan University and Professor Wang Yufei from the Sixth People's Hospital Affiliated to Shanghai Jiaotong University attended the "Chinese Type 2 Diabetes Prevention and Treatment Guidelines (2020 Edition)" New Highlights Interpretation Meeting held in Shanghai.
Two of them Experts have made an in-depth interpretation of the new standard for diabetes diagnosis-glycosylated hemoglobin (HbA1c), and the following extracts the key content to share with you.
HbA1c is included in the diagnostic criteria for type 2 diabetes in my country for the first time, and guides the entire diagnosis and treatment of diabetes.
According to the "Guide" analysis and update on the epidemiology of diabetes in my country, the prevalence of diabetes in my country is still rising, reaching 11.
2% from 2015 to 2017; the proportion of undiagnosed diabetes Although the diabetes awareness rate (36.
5%), treatment rate (32.
2%) and control rate (49.
2%) have improved, they are still at a low level.
Early diagnosis, timely intervention, accurate monitoring of blood glucose levels and controlling them within the ideal range are essential to delay the occurrence and development of diabetes complications and improve the overall diagnosis and treatment of diabetes.
As one of the important update points of the "Guide", HbA1c was formally included in the diagnostic criteria for diabetes.
The "Guide" clearly states: In laboratories with strict quality control, HbA1c measured by standardized testing methods can be used as a supplementary diagnostic criteria for diabetes.
. The complete diagnostic criteria for diabetes in the "Guide" are as follows: Professor Bian Hua pointed out: "Compared with the traditional clinical diagnostic indicators of diabetes-oral glucose tolerance test (OGTT) and fasting blood glucose (FPG), HbA1c concentration represents nearly 2- The 3-month average blood glucose level and the low biological variability within the individual are the'gold standard' for evaluating the long-term blood glucose control level of diabetic patients.
The update of the Guidelines to include HbA1c in the diagnostic criteria will improve the efficiency of the diagnosis of diabetes and Accuracy and reducing the missed diagnosis rate of diabetes are of great significance.
"Professor Bian Hua HbA1c is not only used for diagnosis, but also a key indicator of clinical follow-up.
The "Guide" added a new "main influencing factor" for the setting of individualized HbA1c control goals, and clarified that HbA1c control goals should follow the principles of individualization: younger age, shorter course of disease, longer life expectancy, no complications, no mergers Cardiovascular disease type 2 diabetes (T2DM) patients can adopt more stringent HbA1c control goals (such as <6.
5%, even as close to normal as possible) without hypoglycemia and other adverse reactions.
On the contrary, adopt relatively loose HbA1c Target, HbA1c control target should be adjusted in time according to actual situation.
The main factors influencing the setting of individualized HbA1c control goals for adult patients with type 2 diabetes The update of the "Guide" on the path of diagnosis and treatment of diabetes is also one of the focuses of clinical attention.
In the new version of the path, life>
If blood glucose control is not up to that HbA1c≥7.
0% goes to the next treatment.
"Professor Bian Hua stressed that" at the same time, complications and comorbidities in patients with T2DM is an important basis for selecting hypoglycemic agents.
for example, for a combined arterial Patients with atherosclerotic cardiovascular disease (ASCVD) or T2DM with high cardiovascular risk, regardless of whether their HbA1c meets the standard, as long as there is no contraindication, should be added to metformin with glucagon-like peptides with evidence of ASCVD benefit 1 Receptor agonist (GLP‑1RA) or sodium-glucose cotransporter 2 inhibitor (SGLT2i).
"The simple path of hyperglycemia treatment for type 2 diabetic patients strictly controls laboratory quality, and promotes the standardization of HbA1c detection as the "gold standard" for diabetes diagnosis and treatment monitoring.
The clinical application value of HbA1c detection has obvious advantages, and its application scope covers the screening and diagnosis of diabetes.
And predicting the risk of complications.
However, due to the wide variety of HbA1c testing methods and different testing standards, China has not been able to officially include HbA1c in the diagnostic criteria for diabetes for a long time.
"This "Guide" applies to HbA1c testing.
The clear norms of the company can be said to be expected, and it is also an important breakthrough achieved after a long period of running-in and exploration.
"Professor Wang Yufei pointed out, "The point that needs to be particularly emphasized is that the inclusion of HbA1c in the diagnostic criteria has an important prerequisite, that is, it is necessary to use standardized detection methods for HbA1c determination in a laboratory with strict quality control.
my country started the "China Glycated Hemoglobin Education Program" in 2010, and issued a series of guidance documents such as the "Glycated Hemoglobin Analyzer Industry Standard" and "Glycated Hemoglobin Laboratory Testing Guide".
The standardization of HbA1c testing has been greatly improved.
It is believed that the update of the "Guide" will play an important role in promoting the continuous progress of my country's HbA1c testing standardization level and the construction of laboratory quality control.
"Professor Wang Yufei Different detection methods will be affected by different interference factors, so the standardization of the test is very important to ensure the accuracy of the test results.
The National Glycosylated Hemoglobin Standardization Program (NGSP) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) ) Has been committed to advancing the global standardization of HbA1c determination, and IFCC has also established an internationally recognized reference system.
Professor Wang Yufei pointed out: "Using reliable methods for testing is the basic prerequisite for ensuring the quality of test results.
For laboratories, to meet the "Guide" standards, on the one hand, they must choose high-quality instruments and supporting reagents, and pay attention to whether related products have NGSP and IFCC certification; on the other hand, laboratories should strengthen quality control management and actively participate The inter-office quality assessment organized by the national health administrative department, such as the China Glycated Hemoglobin Conformance Program (CGSP), which is currently being promoted, can ensure that the laboratory’s hardware equipment and testing procedures are in compliance with the standards and are capable of clinical Provide accurate test results.
"Ms.
Zheng Peishan, Roche Diagnostics China Professional and Molecular Diagnostics Department, Clinical and Laboratory Senior Marketing Director, Ms.
Zheng Peishan, said: "As a global leader in the field of in vitro diagnostics, Roche Diagnostics has always been committed to the innovation and research and development of diabetes management solutions, while actively promoting The clinical value promotion and standardization process of domestic HbA1c detection.
The Roche Diagnostics Tina-quant HbA1c test can effectively avoid the interference of common hemoglobin variants.
It has dual certification of IFCC and NGSP, which can effectively ensure the accuracy and efficiency of the test results.
In the future, Roche Diagnostics will continue to work with domestic and foreign clinical and laboratory experts to contribute to improving the level of diabetes diagnosis and treatment in China and benefit more Chinese patients.
"This article is only used to provide scientific information to medical and health professionals, and does not represent the platform's position.
" For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cn
With the new standards for diabetes diagnosis, it is necessary to grasp the accuracy of detection methods.
The "Chinese Type 2 Diabetes Prevention and Control Guide (2020 Edition)" (hereinafter referred to as "Guide") was officially released in April this year.
Compared with the previous edition, the new "Guide" has updated the main points in many aspects such as the diagnostic criteria, treatment path and blood glucose monitoring and management of type 2 diabetes (T2DM).
Recently, Professor Bian Hua from Zhongshan Hospital Affiliated to Fudan University and Professor Wang Yufei from the Sixth People's Hospital Affiliated to Shanghai Jiaotong University attended the "Chinese Type 2 Diabetes Prevention and Treatment Guidelines (2020 Edition)" New Highlights Interpretation Meeting held in Shanghai.
Two of them Experts have made an in-depth interpretation of the new standard for diabetes diagnosis-glycosylated hemoglobin (HbA1c), and the following extracts the key content to share with you.
HbA1c is included in the diagnostic criteria for type 2 diabetes in my country for the first time, and guides the entire diagnosis and treatment of diabetes.
According to the "Guide" analysis and update on the epidemiology of diabetes in my country, the prevalence of diabetes in my country is still rising, reaching 11.
2% from 2015 to 2017; the proportion of undiagnosed diabetes Although the diabetes awareness rate (36.
5%), treatment rate (32.
2%) and control rate (49.
2%) have improved, they are still at a low level.
Early diagnosis, timely intervention, accurate monitoring of blood glucose levels and controlling them within the ideal range are essential to delay the occurrence and development of diabetes complications and improve the overall diagnosis and treatment of diabetes.
As one of the important update points of the "Guide", HbA1c was formally included in the diagnostic criteria for diabetes.
The "Guide" clearly states: In laboratories with strict quality control, HbA1c measured by standardized testing methods can be used as a supplementary diagnostic criteria for diabetes.
. The complete diagnostic criteria for diabetes in the "Guide" are as follows: Professor Bian Hua pointed out: "Compared with the traditional clinical diagnostic indicators of diabetes-oral glucose tolerance test (OGTT) and fasting blood glucose (FPG), HbA1c concentration represents nearly 2- The 3-month average blood glucose level and the low biological variability within the individual are the'gold standard' for evaluating the long-term blood glucose control level of diabetic patients.
The update of the Guidelines to include HbA1c in the diagnostic criteria will improve the efficiency of the diagnosis of diabetes and Accuracy and reducing the missed diagnosis rate of diabetes are of great significance.
"Professor Bian Hua HbA1c is not only used for diagnosis, but also a key indicator of clinical follow-up.
The "Guide" added a new "main influencing factor" for the setting of individualized HbA1c control goals, and clarified that HbA1c control goals should follow the principles of individualization: younger age, shorter course of disease, longer life expectancy, no complications, no mergers Cardiovascular disease type 2 diabetes (T2DM) patients can adopt more stringent HbA1c control goals (such as <6.
5%, even as close to normal as possible) without hypoglycemia and other adverse reactions.
On the contrary, adopt relatively loose HbA1c Target, HbA1c control target should be adjusted in time according to actual situation.
The main factors influencing the setting of individualized HbA1c control goals for adult patients with type 2 diabetes The update of the "Guide" on the path of diagnosis and treatment of diabetes is also one of the focuses of clinical attention.
In the new version of the path, life>
If blood glucose control is not up to that HbA1c≥7.
0% goes to the next treatment.
"Professor Bian Hua stressed that" at the same time, complications and comorbidities in patients with T2DM is an important basis for selecting hypoglycemic agents.
for example, for a combined arterial Patients with atherosclerotic cardiovascular disease (ASCVD) or T2DM with high cardiovascular risk, regardless of whether their HbA1c meets the standard, as long as there is no contraindication, should be added to metformin with glucagon-like peptides with evidence of ASCVD benefit 1 Receptor agonist (GLP‑1RA) or sodium-glucose cotransporter 2 inhibitor (SGLT2i).
"The simple path of hyperglycemia treatment for type 2 diabetic patients strictly controls laboratory quality, and promotes the standardization of HbA1c detection as the "gold standard" for diabetes diagnosis and treatment monitoring.
The clinical application value of HbA1c detection has obvious advantages, and its application scope covers the screening and diagnosis of diabetes.
And predicting the risk of complications.
However, due to the wide variety of HbA1c testing methods and different testing standards, China has not been able to officially include HbA1c in the diagnostic criteria for diabetes for a long time.
"This "Guide" applies to HbA1c testing.
The clear norms of the company can be said to be expected, and it is also an important breakthrough achieved after a long period of running-in and exploration.
"Professor Wang Yufei pointed out, "The point that needs to be particularly emphasized is that the inclusion of HbA1c in the diagnostic criteria has an important prerequisite, that is, it is necessary to use standardized detection methods for HbA1c determination in a laboratory with strict quality control.
my country started the "China Glycated Hemoglobin Education Program" in 2010, and issued a series of guidance documents such as the "Glycated Hemoglobin Analyzer Industry Standard" and "Glycated Hemoglobin Laboratory Testing Guide".
The standardization of HbA1c testing has been greatly improved.
It is believed that the update of the "Guide" will play an important role in promoting the continuous progress of my country's HbA1c testing standardization level and the construction of laboratory quality control.
"Professor Wang Yufei Different detection methods will be affected by different interference factors, so the standardization of the test is very important to ensure the accuracy of the test results.
The National Glycosylated Hemoglobin Standardization Program (NGSP) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) ) Has been committed to advancing the global standardization of HbA1c determination, and IFCC has also established an internationally recognized reference system.
Professor Wang Yufei pointed out: "Using reliable methods for testing is the basic prerequisite for ensuring the quality of test results.
For laboratories, to meet the "Guide" standards, on the one hand, they must choose high-quality instruments and supporting reagents, and pay attention to whether related products have NGSP and IFCC certification; on the other hand, laboratories should strengthen quality control management and actively participate The inter-office quality assessment organized by the national health administrative department, such as the China Glycated Hemoglobin Conformance Program (CGSP), which is currently being promoted, can ensure that the laboratory’s hardware equipment and testing procedures are in compliance with the standards and are capable of clinical Provide accurate test results.
"Ms.
Zheng Peishan, Roche Diagnostics China Professional and Molecular Diagnostics Department, Clinical and Laboratory Senior Marketing Director, Ms.
Zheng Peishan, said: "As a global leader in the field of in vitro diagnostics, Roche Diagnostics has always been committed to the innovation and research and development of diabetes management solutions, while actively promoting The clinical value promotion and standardization process of domestic HbA1c detection.
The Roche Diagnostics Tina-quant HbA1c test can effectively avoid the interference of common hemoglobin variants.
It has dual certification of IFCC and NGSP, which can effectively ensure the accuracy and efficiency of the test results.
In the future, Roche Diagnostics will continue to work with domestic and foreign clinical and laboratory experts to contribute to improving the level of diabetes diagnosis and treatment in China and benefit more Chinese patients.
"This article is only used to provide scientific information to medical and health professionals, and does not represent the platform's position.
" For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cn
