recent study is recommending using HgA1C now as a diagnostic tool for DM. The recommendations suggest that when A1C is >6.5%, confirmed with repeat testing, a diagnosis can be suspected of DM.
I think this is a great idea and hopefully we can pick up more cases of DM earlier in this case.
However, an editorial in JASN brings up some good points in setting of CKD and transplant patients?
1. Anemia of kidney disease and how does that affect the HgA1C, in the setting of treatment with erythropoetin stimulating agents? How does that alter the diagnostic criteria?
2. Does the state of uremia alter the HgA1c?
3. Can this test be used in ESRD and dialysis patients at all due to increased inflammatory state and on going blood loss?
4. Post transplant - can HgA1c predict onset of NODAT? Perhaps using pre transplant values can predict NODAT? who knows?
Good things to consider and study in years to come as HgA1c becomes a more standard of care for diagnosis of DM.
Please see the following link:
Image source: http://mset.rst2.edu/msn/s/soper_m/sget650/module3/newa1c.jpg
- ► 2017 (37)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- CLINICAL CASE 9
- The Online Transplant Center: Post transplant MPGN...
- Post transplant MPGN
- TOPIC DISCUSSION: PCO2, which one is better?
- Image Quiz- Answers
- CONSULT ROUNDS: METHANOL and the EYE?
- CONSULT ROUNDS: ACID BASE
- JOURNAL CLUB: Kidney allograft nephrectomy can imp...
- TOPIC DISCUSSION: Nutrition
- TOPIC DISCUSSION: Drugs and Cyclosporine
- IN THE NEWS- NSF and Kidney Transplantation
- Bowel Transplantations, not enough!
- Horseshoe Kidney
- The Online Transplant Center: New Agents for renal...
- CLINICAL CASE 8
- History of Nephrology: The first randomised contro...
- Common Sense vs. Evidence-based Medicine
- TOPIC DISCUSSION: DIFFERENT TYPES OF PROTEINURIA
- New Agents for renal transplantation
- TOPIC DISCUSSION: Renal Artery Stenosis
- TOPIC DISCUSSION: THE WWW and the NEPHROLOGIST
- IN THE NEWS- Hyperkalemia treatment in trouble
- IN THE NEWS ---> ACUTE KIDNEY INJURY
- CONSULT ROUNDS: SIADH and Escitalopram ( lexapro)...
- CONSULT ROUNDS: Clinical dilemma in Nephrogenic Di...
- CONSULT ROUNDS: Metformin toxicity, Lactic Acidosi...
- CLINICAL CASE 7
- IN THE NEWS- HgA1C for Diabetes Diagnosis. How abo...
- KIDNEY DONORS have Good Long term survival
- TOPIC DISCUSSION: VEGF Nephropathology
- TOPIC DISCUSSION: Post Transplant Collapsing FSGS,...
- Post Transplant Collapsing FSGS: Is it really all ...
- CLINICAL CASE 6
- Topic Discussion: OUCH!! Should Anesthesia Hurt?...
- TOPIC DISCUSSION: Alcohol Poisonings, gaps and osm...
- Belatacept approved by FDA
- Protocol Biopsies in Renal Allograft Recipients
- ▼ March (37)