Trends in Laboratory Testing Practice for Diabetes Mellitus

BACKGROUND: India, with diabetes mellitus (DM) prevalence of nearly 7%, contributes 20% of the DM population in the world. The diagnosis and management of DM is largely dependant on laboratory parameters. We aimed to survey the laboratory testing practices for DM in this country. METHODS: A survey of 890 practising Laboratorians in India was conducted through Survey Monkey. RESULTS: A total of 310 (35%) complete responses were received. The majority of respondents worked in academic institutions, public hospital laboratories and private hospital laboratories. HbA1c was approved for diagnosis in 75% of laboratories. The HbA1c method was NGSP (National Glycohaemoglobin Standardisation Programme) certified in 70% of laboratories only. Oral glucose tolerance testing (OGTT) was recommended for diagnosis of gestational diabetes (GDM) in 56% of respondents. Fifty-nine percent respondents recommended an early morning urine sample for microalbuminuria testing whilst 39% and 2% opted for 24 hour urine and timed overnight sample respectively. Sixty-six percent participated in proficiency testing (PT) for both glucose and HbA1c. Twelve percent and 4% respondents respectively participated in PT for glucose only and HbA1c only, and 9% participated in PT for neither. CONCLUSIONS: Based on the above survey we recommend that Scientific bodies and Professional Associations in India should educate Laboratorians to adopt NGSP certified methods for HbA1c testing and morning spot sample for microalbuminuria testing. DIPSI (Diabetes in Pregnancy Study Group in India) guidelines for diagnosis of Gestational diabetes since it is a simple, single step procedure, non-fasting, cost effective, feasible method should be implemented.