Axis-Shield PoC - Diabetes

Introduction

Diabetes constitutes a heavy burden for the patient and the society. It is associated with many complications and increased mortality.

Complication and mortality rates further increase with smoking, obesity, hypertension, increased cholesterol and triglyceride, proteinuria, and poor glucose control. Early diagnosis, good glucose monitoring and control are crucial to reduce the burden of diabetes.

The confirmation of diagnosis of diabetes long relied on determination of blood/plasma glucose. Also for monitoring of treatment blood glucose levels was the only available tool. Glucose levels, however fluctuates considerably depending on food intake and other factors, being lowest in the morning before breakfast and then increases more or less after meals, depending both on the diet and the individual glucose regulation with higher levels and greater variations diabetes. To diagnose earlier stages of diabetes, at least two plasma/blood glucose tests on different days are required. These measurements require compliance to fasting before sampling. Moreover fasting values do not say anything about the increase after meals. An oral glucose tolerance test (OGTT) is therefore sometimes also required. Values are then determined 2 hours after an oral dose of 75 g of glucose, a time consuming test. Although these methods are useful, alternatives, reflecting the mean glucose levels during a longer period, have been sought for to simplify diagnosis and monitoring.

As various sugars bind to some degree to proteins in different tissues to more or less stable adducts that can be analysed, methods based on such adducts have been developed. These reflect the glucose levels for a longer or shorter previous period of time and. One of the proteins to which glucose binds is hemoglobin. This protein has very special properties that make the fraction of hemoglobin bound to glucose a very useful marker of impaired glucose turnover that reflects the mean blood glucose level during the preceding weeks.

The fraction of hemoglobin that is bound to glucose - HbA1c - now serves as a powerful tool for assessing long-term glycemic control. HbA1c also correlates well with the risk of development of complications related to diabetes, which is a very important aspect. In the future HbA1c is likely to become a useful tool also for the diagnosis and evaluation of all forms of diabetes mellitus and patients at risk of developing diabetes, making it possible to discover diabetes earlier.

The new AfinionTM Analyzer System developed by Axis-Shield and based on a patented test method makes it possible to easily and rapidly determine HbA1c at the physician’s office. This system will simplify monitoring of any type of diabetes facilitating treatment management, and prevention of late complications. It may also increase the patient’s motivation to comply with treatment and lifestyle changes to optimise prognosis.