Medics rooting for new methods in screening diabetes

By ALLY JAMAH  

NAIROBI, KENYA: Medical experts are recommending for a better and advanced way of screening and monitoring diabetes in order to boost the fight against the disease that is ravaging thousands of Kenyans.  

The test, called Glycated Haemoglobin or HbA1c, is not widely used in the country but it easily reveals  the people who are the highest risk of developing diabetes, even when early symptoms like frequents feelings of thirst and urination haven’t become manifest. This is because it looks out for the disease deep inside blood cells. 

According to Dr. Ahmed Kalebi of Pathologists Lancet Kenya, one of the largest network of private clinical laboratories, even before onset of diabetes, the advanced test would reveal how much sugar  is in the blood  cells. 

If it is high, then there is elevated risk of developing diabetes and the concerned individual would be required to take extra measures to protect themselves from the disease.  

"This would be useful since people with the highest risks of developing the disease may make drastic lifestyle improvement to delay or eliminate the disease from developing into a full-blown condition that is irreversible," he says.  

The use of this test in screening for diabetes is the new trend around the globe  and  endorsed by various international bodies including World Health Organisation and American Diabetes Association.  

The test is also considered more effective and reliable than traditional diabetes tests since it is  able to reveal with unprecedented clarity a patient's blood sugar levels for the previous three months.  

The other tests currently in use cannot do this feat. Such information would help a doctor see how his or her patients has been controlling blood sugar and make appropriate interventions.  

Dr. Ruchika Kohli, a clinical pathology expert based in Nairobi who frequently tests patients for diabetes and advises doctors on the same says that accuracy of other tests for diabetes currently in use are easily affected if the patients consumes food or drink a few hours before the test, but this is not the case with the advanced test being recommended.  

No prior fasting is necessary as food intake does not affect the test and patient preparation, appointments and special dietary requirements which normally apply  to other tests are  not necessary. 

" Some diabetes patients may attempt to secure a good blood glucose result by abstaining from food overnight, thereby cheating the system. But this is impossible under the new tests. This may encourage more diabetes patients to live more responsibly in line with the advice of their doctor to manage the condition better,"  she says. 

Ministry of Health officials and some medical doctors have been expressing concern that many Kenyans living with diabetes may not be strictly following guidelines given by their doctors to manage the disease thereby increasing the likelihood of developing more serious complications like heart attacks, strokes and eye  blindness.

The patients' may  disregard the nutritional guidelines from their doctors if they lack self-discipline to abstain from their favorite  dishes or drink that have been outlawed for him or her. 

 The advanced test also enables people living with diabetes to better  gauge their risks of developing diabetes-related complications such  poor eyesight, possible amputation of limbs, heart attacks and others.  This is because the  higher the glucose level in the red blood cells, the greater the risk of developing diabetes-related complications. 

" A patient who finds out through accurate tests that he or she is more likely to suffer complications will be forced to do more to control the diabetes-control regime set out by the doctor, rather than the one who is advised  generally about the possibilities of complication," she says.

Unfortunately, despite its many benefits in the war against diabetes, the advanced tests is still not widely used in Kenya, with only a few people benefiting from it. Majority of public hospital don’t offer the test. Many medical professionals and patients are also not aware that the tests exists with all its benefits.  

Also, the relatively high costs of the advanced test may be a big hindrance to its wide uptake as it costs between Sh800 and Sh2000 compared to the ordinary blood sugar test which costs between Sh100 to Sh400. 

"Efforts should be made by various government and non-governmental agencies to ensure the advanced test is made more widely available in health facilities at affordable rates particularly now diabetes is among the top killers in Kenya," Dr. Kalebi concludes.