Diabetes test ‘may be inaccurate for thousands of South Asian people in UK’

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Diabetes checks used in the UK might be placing tens of thousands of South Asian people in danger of getting false outcomes, new analysis suggests.

The analysis recognized a genetic variant amongst people of South Asian heritage that impacts the outcomes of a diabetes test.

A test used for kind 2 diabetes in the UK, which measures common blood sugar ranges, might give falsely decrease outcomes in South Asian people who carry this genetic variant, resulting in delayed prognosis in line with a brand new examine.

Data means that there are greater than 420,000 people from a South Asian background dwelling with diabetes in England, and greater than 230,000 have a prognosis of prediabetes and are due to this fact at excessive threat of creating kind 2 diabetes.

The information comes after an unbiased authorities evaluate of medical gadgets used to test blood oxygen ranges. The gadgets had been discovered to have racial biases which overestimate oxygen ranges in people with darker pores and skin tones.

With round 7.6 per cent of South Asians carrying this variant, this means the HbA1c test is underestimating blood sugar ranges in round 32,000 South Asian people with diabetes and 17,500 with prediabetes in England alone.

The test is essential for diagnosing kind 2 diabetes, monitoring prediabetes, and guiding diabetes therapy.

Dr Miriam Samuel at Queen Mary University London and colleagues in the Genes and Health Research Team recognized the genetic variant that’s discovered in 7.6 per cent of people of South Asian heritage however is uncommon in different ethnicities.

Dr Samuel mentioned: “Many genetic variants linked to red blood cell conditions are ultra-rare amongst the Northern Europeans who have historically dominated genetic studies.

“We demonstrate one such variant that is carried by 7.6 per cent of South Asians which could affect the accuracy of HbA1c and cause delays in diabetes diagnosis.

“Studies such as Genes and Health, focusing on populations who are underserved in genetic research, are vital to understand the different pathways that may contribute to diabetes inequalities in these communities.”

Dr Elizabeth Robertson, director of analysis at Diabetes UK, mentioned: “This evidence showing that the accuracy of a common test to diagnose and monitor type 2 diabetes is linked to a person’s ethnicity should be urgently investigated further.

“It’s incredibly important that healthcare professionals are armed with a precise way to evaluate average blood sugar levels over extended periods.

“Without this, they are navigating in the dark and potentially at risk of overlooking cases of type 2 diabetes.

“Every individual at risk or with diabetes, regardless of their background, deserves equal access to effective diabetes care to live a healthy life and mitigate long-term diabetes complications.”

The researchers checked out genetic and well being knowledge from the Genes and Health examine – which included greater than 60,000 people of Bangladeshi or Pakistani ethnicity dwelling in England – and the UK Biobank.

They discovered that people with this gene had been discovered to have falsely decrease HbA1c ranges and variations in their full blood rely.

HbA1c checks estimate common blood sugar ranges by measuring how a lot sugar is connected to haemoglobin in purple blood cells.

The analysis means that the genetic variant is linked to adjustments in purple blood cells, and that this impacts HbA1c test outcomes.

According to the findings, people who had one copy of the genetic variant had been identified with kind 2 diabetes on common one 12 months later.

While these with two copies had been identified on common two years later, than these with out the genetic variant.

Inaccurate outcomes may also imply people don’t obtain well timed and acceptable remedies wanted to handle blood sugar ranges and cut back threat of long-term problems, which may embody coronary heart assaults, strokes, amputations, and sight loss, the consultants recommend.

The findings point out extra blood sugar testing, akin to fasting glucose and oral glucose tolerance checks, and different monitoring strategies may be wanted in South Asian people who carry the variant.

The findings will be offered on the Diabetes UK Professional Conference 2024.