Abstract:
Numerous laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially. An expert committee compiled evidence-based recommendations for laboratory analysis in patients with diabetes. The overall quality of the evidence and the strength of the recommendations were evaluated. The draft consensus recommendations were evaluated by invited reviewers and presented for public comment. Suggestions were incorporated as deemed appropriate by the authors (see Acknowledgments in the full version of the guideline). The guidelines were reviewed by the Evidence Based Laboratory Medicine Committee and the Board of Directors of the American Association for Clinical Chemistry and by the Professional Practice Committee of the American Diabetes Association.
Diabetes can be diagnosed by demonstrating increased concentrations of glucose in venous plasma or increased hemoglobin A1c (HbA1c) in the blood. Glycemic control is monitored by the patients measuring their own blood glucose with meters and/or with continuous interstitial glucose monitoring devices and also by laboratory analysis of HbA1c. The potential roles of noninvasive glucose monitoring; genetic testing; and measurement of ketones, autoantibodies, urine albumin, insulin, proinsulin, and C-peptide are addressed.
The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.
摘要:
背景:许多实验室检查用于糖尿病患者的诊断和治疗。支持使用这些测定法的科学证据的质量变化很大。专家委员会为糖尿病患者的实验室分析编制了基于证据的建议。评估了证据的总体质量和建议的强度。特邀审核员对协商一致建议草案进行了评估,并提出征求公众意见。作者认为适当时纳入了建议(见指南完整版中的致谢)。该指南由美国临床化学协会的循证实验室医学委员会和董事会以及美国糖尿病协会的专业实践委员会进行了审查。
背景:可以通过证明静脉血浆中葡萄糖浓度增加或血液中血红蛋白A1c(HbA1c)增加来诊断糖尿病。通过患者用仪表和/或用连续间质葡萄糖监测装置测量他们自己的血糖并且还通过HbA1c的实验室分析来监测血糖控制。无创葡萄糖监测的潜在作用;基因检测;和酮的测量,自身抗体,尿白蛋白,胰岛素,胰岛素原,和C-肽被寻址。
结论:本指南根据已发表的数据或根据专家共识提供具体建议。目前发现几种分析物具有最小的临床价值,并且不建议测量它们。