Lab meds and NCDs
LABORATORY medicine is a diagnostic tool which provides a variety of laboratory tests to primary healthcare. Laboratory medicine also has a significant role to play by application of evidence-based medicine.
The contribution of laboratory medicine is essential in modern healthcare, since in vitro diagnostic testing plays a pivotal role for predicting disease susceptibility, for establishing effective preventative measures, for making diagnoses, especially at an early stage, but also for prognosticating and monitoring diseases.
This includes laboratory tests for infectious and non-communicable diseases (NCDs). NCDs such as cancer and diabetes are becoming increasingly important, as their rates have been rising.
This article will discuss NCDs with especial focus on Diabetes and the common Laboratory tests related to it.
It has been stated that laboratory testing directly affects 70 per cent of the clinical decisions in the patient pathway (Collinson, 2017).
For instance, cardiac biomarker measurement has had a crucial role in defining diagnosis, management strategies and latterly treatment options in patients with ischaemic heart disease (Collinson, 2017).
The progressive evolution of cardiac biomarker measurement ultimately resulted in the introduction of troponin testing. Measurement of cardiac troponin provides diagnostic information but also serves as the key test to direct the patient along therapeutic pathways (Collinson, 2017).
Furthermore, of the six World Health Organization (WHO) regions, the European region is the most affected by NCDs-related morbidity and mortality and the growth of the NCDs is concerning (Kluge, Wickramasinghe, Rippin, Mendes, & Peters, 2020).
Cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes are among the leading causes of death and disability in the region (Kluge, Wickramasinghe, Rippin, Mendes, & Peters, 2020). Studies have described non-communicable diseases as ‘rising burden in healthcare’ (Horton, et al., 2018).
In some countries rising burden of non-communicable diseases is crippling the nation’s healthcare systems including the national healthcare budget (Kleinert & Horton, 2018).
For instance, the growing burden of diabetes is another example of non-communicable diseases and where Laboratory medicine is one of the fundamental important missing pieces for better control and treatment (Kleinert & Horton, 2018; Wilson).
Moreover, early identification of diseases, especially in asymptomatic patients, enables better management and use of both public and private economic resources (Plebani, Laposata, & Lippi, 2019). Type 2 diabetes is increasing in prevalence worldwide at an alarming rate (Kleinert & Horton, 2018).
It is, therefore, crucial for people with diabetes to have not only good glucose control but also optimal control of other cardiovascular risk factors, for example, hypertension, dyslipidaemia, obesity and smoking (Plebani, Laposata, & Lippi, 2019).
Additionally, the Laboratory plays a crucial role in the diagnosis of diabetes as well as in monitoring glycaemic control. HbA1c is now used for both the diagnosis of diabetes and in the assessment of diabetes control (Zunic, et al., 2011).
It is important to ensure that lipid levels are optimised to reduce cardiovascular risk and to monitor patients’ renal function and as well as urine albumin/creatinine ratio (Wilson, Fleming, Kuti, Lai, & Lago, 2018).
Insulin and/or C-peptide measurement may be useful in ascertaining the body’s ability to produce insulin and help differentiate type 1 from type 2 diabetes (Zunic, et al., 2011).The
WHO’s website provides the following information about Diabetes:
The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014.
Type 2 diabetes results from the body’s ineffective use of insulin. As a result, the disease may be diagnosed several years after onset, after complications have already arisen. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.
Type 1 diabetes is characterized by deficient insulin production and requires daily administration of insulin. Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
Early identification of NCDs and direct treatment monitoring are well-established as a part of Laboratory medicine (Collinson, 2017) and for this the Oceania Hospitals (OHPL) will be an ideal place to start with.
The Lab at Oceania Hospitals has been around for more than twenty years. It actively participates in the quality assurance programs offered by Royal College of Pathologists of Australasia (RCPA) and Pacific Pathology Training Centre (PPTC). Over the years the Pathology
Laboratory has developed extensively and has localised many tests.
NCDs related laboratory tests are provided at OHPL Pathology laboratory. Some of these tests are lipids, glucose, renal function tests (RFT), liver function tests (LFT), microalbumin, C-Peptide, insulin, HbA1c, Vitamin D, parathyroid hormone, homocysteine, myoglobin, troponin, thyroid function test (TFT) and tumor markers (AFP, CA 125, CEA, CA 15.3, CA 19.9 and CA 72.4).
As medical laboratory science progresses with innovation, OHPL Pathology Laboratory will continue to introduce new and improved technology and test methods.
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