National Health Expenditure (NHE)
Thanks to advances in agriculture and food processing, Diabetes has become an epidemic that is affecting nearly thirty million Americans. National Health Expenditure (NHE) has recorded a whopping three trillion dollars in 2014 on diabetes.1 In recent years, more than twenty percent of the NHE has been spent on Diabetes diagnosis and management. The Diabetes by itself is of no importance. But the complications of diabetes are wide, including kidney failure, heart attack, blindness, amputation and sexual dysfunction. Early diagnosis and intervention has proven to be the most effective method for combating diabetes. For many years, fasting blood glucose was the main method of diagnosis. …show more content…
Doctors have to be careful when they order this test in cases that may compromised the readings. HBa1c depends on RBC. If there is a recent major blood loss or blood transfusion, it can dilute the HBa1c level and result in lower values. Other factors that have been shown to cause bad readings is race, age, and gender of the patient.1 In some races, especially in First Nation Americans, it is possible to miss diabetes due to lower values. Other factors that can invalidate the values are pregnancy and recent major change in diet. In case of pregnancy, the body will be carrying glucose for two people, which makes reading HBa1c near impossible. It is recommended to use Oral Glucose Tolerance Test in pregnant women. In case of major diet, some bodybuilders and strength trainers may have a sudden shift in their diet that can cause a transient change in their HBa1c. Even though they are healthy, wrong values may be read. The test itself has no complication, but a correct and early diagnosis can help the patient to avoid the complications of diabetes in the long run.
One of the best statistical ways to measure accuracy and usability of a test is looking at the sensitivity and specificity of the test. These values are obtained by comparing the number of results to another gold standard test. In the case of HBa1c, these values are compared to fasting blood glucose level. HBa1c of 6.5% has 75% sensitivity and 85% specificity for diabetes.1 These values can increase in individuals that are obese or from certain races such as Hispanic or African American