The Power of Knowing: Diagnostics for People Living with Diabetes
Early diagnosis, sometimes even before an illness starts, can play a critical role in helping prevent disease, hospitalization, and death.
People with diabetes are three times more likely to experience complications of cardiovascular disease, such as stroke, heart attack, or heart failure.1 But advanced diagnostics can detect changes in the body even before a disease occurs, helping identify if a patient with diabetes is at higher risk of cardiovascular disease. This allows health care providers and patients to make critical decisions sooner, enabling targeted prevention and treatment, reducing illness, hospitalizations, and deaths.
Diagnostics are tests that detect diseases, conditions, and infections. And while much attention is paid to what happens after a diagnosis, in-vitro diagnostics are a crucial part of a patient’s health journey and influence about 70 percent of clinical decision-making.2
Most diagnostics are based on biomarkers. “A biomarker is any type of measured signal that comes from the body that can indicate the presence of a disease or if a disease or complication is going to develop in the future,” says Dr. Abhinav Sharma, a cardiologist at McGill University Health Centre and Assistant Professor in the Department of Medicine in the Faculty of Medicine and Health Sciences at McGill University.
Biomarker testing transforming the standard of care
Biomarkers can include blood pressure and heart rate, blood and urine tests, or a test like an electrocardiogram. The role of biomarkers has become essential in transforming the standard of care for many diseases. Biomarker testing potentially provides an opportunity to know more about what can be done in terms of treatment or lifestyle changes before a patient becomes sick, allowing their health care provider to make better decisions with more confidence.
It is amazing how much information can be found in a small blood or tissue sample — and how much that information could change someone’s life, leading to lifestyle interventions or medical treatments that can keep them healthy. A test might find a more serious threat and lead to a life-saving decision.
Advances in diagnostics are leading to a new level of insights, contributing to better patient outcomes and enabling health care providers to provide more personalized treatment. Technologies like machine learning and artificial intelligence are opening the door to even more possibilities, leading to more accurate, earlier detection. For example, Dr. Sharma is involved in research examining the role of wearable devices to help detect if a patient may be at risk for diabetes.
Early detection allows patients and doctors to be more proactive
Health care providers can use many diagnostic tools together to achieve the best possible outcomes. “For example, we can create a risk score, by taking a patient’s biomarkers and their medical history, to see whether they are at high risk of developing cardiovascular disease,” Dr. Sharma says. “We need to be very proactive in trying to identify those who may be at the highest risk of developing complications from diabetes, because often, complications like heart failure can slowly progress with no symptoms and then are found at a later stage.”
Heart failure is one of the main complications of diabetes, says Dr. Sharma, and can lead to serious illness and death. For Canadians over age 65, it is the second most common cause of hospitalization.3
One way to detect if someone is at increased risk of heart failure is a blood test for NT-proBNP, a type of natriuretic peptide, which are hormones that are made by the heart when its wall is stretched.
“Research shows that even if a person is feeling reasonably well, natriuretic peptides are often released because the heart is undergoing subtle changes. This may give an early clue that heart failure may develop,” Dr. Sharma says. “Once we have this information, there is reason for hope. Because now we can take steps to prevent it [heart failure] from happening.”
Early diagnosis and risk identification can also empower patients. This is why it is important for people living with diabetes to ask their health care providers about available diagnostic tools. If a patient knows their risk factors or has an accurate diagnosis, they can be involved in treatment decisions and take steps to change their lifestyle. This not only improves their health and reduces the risk of hospitalization, it can also give them a greater sense of control — something that can feel absent when living with a chronic disease.