Researchers have developed a novel test that rapidly distinguishes between type 1 and type 2 diabetes. This new method and a second study revealing gaps in care for women with gestational diabetes were presented today at the 70th AACC Annual Scientific Meeting & Clinical Lab Expo, and could improve treatment for patients with all diabetes types across the board.
One major issue in diabetes care today is the difficulty in distinguishing type 1 diabetes from type 2. Type 1 and type 2 diabetes require very different treatment plans, but up to 15% of diabetic young adults are wrongly classified and treated, which can lead to dangerous complications. Another challenge in diabetes care is preventing type 2 diabetes in women who have had gestational diabetes. Because half of women who have had gestational diabetes go on to develop type 2 diabetes, guidelines encourage these women to undergo diabetes testing six weeks after giving birth so they can receive preventive treatment if they are at risk. It is unknown, however, how consistently this follow-up testing is performed worldwide.
Correctly Diagnosing Type 1 and Type 2 Diabetes
A research team led by Mark Latten of Randox Laboratories and Richard Oram, MD, of the University of Exeter Medical School in the U.K., has developed a new test intended to diagnose type 1 diabetes more effectively. The test, named the Type 1 Diabetes GRS array, screens for 10 heritable mutations associated with a predisposition to type 1 diabetes, and combines the measurements into a genetic risk score. In an initial validation study, the researchers analyzed 259 DNA samples with the GRS array and an established genetic testing method, and found that the GRS array successfully detected the same combinations of the 10 mutations in the samples compared with the established method. This indicates that the test could serve as a vital tool for preventing the misdiagnosis of diabetes patients.
"No one has, to date, used the known strong genetic risk of type 1 diabetes to distinguish type 1 from type 2," said Oram. "Our assay could be used alone, or in combination with clinical features and autoantibody testing to improve classification of diabetes at diagnosis, and therefore make sure people get on the right treatment."
Preventing Diabetes in Women Post-Pregnancy
A research team led by Lucius Imoh, MBBS, of Jos University Teaching Hospital in Nigeria, set out to determine how many women undergo recommended postpartum glucose testing six weeks after birth. The study followed up with 58 women who were diagnosed as having gestational diabetes or overt diabetes during pregnancy to determine their post-pregnancy testing status.
While many of the women had undergone some form of follow-up testing, only 4 of the 58 were tested with an oral glucose tolerance test (OGTT)-;the gold standard for diagnosing type 2 diabetes-;six weeks after delivery, and eight had no form of glucose testing whatsoever. Furthermore, only 28 of the women had been advised to undergo OGTT after delivery, a sobering finding that indicates inadequate referral for postpartum care was the norm in the study group.
"Our study draws the attention of clinicians and laboratorians to the current state of vagueness in postpartum testing," said Imoh. "It calls attention to this missed opportunity for assessing and preventing diabetes mellitus and cardiovascular diseases in women with gestational diabetes."
Altogether, this underscores the need for labs and clinicians to work together to improve postpartum glucose testing in developing countries such as Nigeria, so that type 2 diabetes onset can be prevented in more women worldwide.