Diabetes Mellitus, and its precursor clinical syndromes, continue to grow in prevalence in developed and developing countries across the world. Until we have better strategies for prevention, we rely on laboratory testing to screen, diagnose and manage these conditions.

The hallmark of diabetes (and prediabetes) is dysglycaemia which results from reduced insulin action either due to deficient pancreatic islet cell production or reduced insulin effectiveness, or resistance. The early presentation of diabetes can be directly due to the hyperglycaemia (eg polyuria and dehydration) and hyperinsulinaemia can also directly cause clinical signs (eg acanthosis nigricans). Our main clinical concerns however, are related to long term impacts of hyperglycaemia which include cardiovascular risk, but also neuropathy, retinopathy and nephropathy. These latter conditions are believed to be indirectly due to hyperglycaemia because it causes protein glycosylation (Advanced Glycation Endproducts / AGE). While the diabetic complications of neuropathy (nerve conduction abnormalities), retinopathy (retinal examination abnormalities) and nephropathy (albuminuria) can be clinically identified, the AGE’s causing them cannot yet be estimated. Nevertheless, laboratory testing of whole blood for glycated haemoglobin (HbA1c) has been established as a powerful prognostic indicator of the dangers of diabetes, so much so that HbA1c is now the preferred method of diagnosing diabetes. 

Each of these laboratory tests; glucose, insulin and HbA1c play vital roles in understanding and managing diabetes and over several decades laboratory professionals have improved their individual strengths, but also identified some significant weaknesses. No laboratory test is perfect, but it is vital that laboratory professionals are aware of any weaknesses and try to mitigate that risk so that the guidance that the laboratory provides to the clinician, and ultimately the patient, can be clear and balanced.

This seminar will allow the participant to identify the weaknesses with the measurement and reporting of glucose, insulin and HbA1c, but also to recognize the laboratory techniques to minimize the risks associated with these weaknesses.

This webinar comprises of three following presentations of 20 min each followed by 20 min of panel discussion at the end. 

Talk 1: Laboratory measurement of glucose [Greg Ward] 

Talk 2: Insulin analysis in hyperglycemia [Paul Williams]

Talk 3: HbA1c – still the gold standard? [Ken Sikaris]

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