HBA1C?

tay-rie, wa caya lu.....sebagai renungan...yes!
Peace not war......no hard feeling.......TQ

hehehe... terkeliru ke... x payah keliru la, memang x sama KK dengan hospital. saudara intang duk KK nanti tahu la sendiri... mungkin x berminat nak duk KK kot.

Ini baru dikatakan pandangan yang membina kot2 kita ada konferens untuk MLT boleh kita voice out tentang hal ni kann apapun KK @ Hospital kerja sama jee cuma yang membezakan kita adalah komitmen kita sendiri kannnn

Boleh cek adakah HBA1c termasuk dalam ujian STAT????..
kat HSA pn x penah lagi dengar HBA1c bt stat..

Emmm HBA1C bukan ujian STAT

emm.. tu la maksud wan, bukan pasal hak query ke apa, ni pasal releven ke x releven test tu di STAT kan. harap xde MLT yg terkeliru dengan konsep perlaksanaan ujian ni.

Apa pun keputusan di tangan anda, sebagai peneraju makmal masing2.

Mana itu PROSEDUR.
Ceritalah sikit....tak usah banyak....
Sikit aje.......Wan!

Intang wrote:Mana itu PROSEDUR.
Ceritalah sikit....tak usah banyak....
Sikit aje.......Wan!

saudara intang,
sebelum melakukan ujian ke atas sample pesakit, alatan perlu di jalankan QC kan?
QC biasa de 2 jenis QC low dan QC high.
sesetengah machine, perlu ade calibration sekali.

jika hanya 1 sample sehari, lebih baik dikumpulkan dan dijalankan sebagai batch test, jimat kos, dan jimat masa pelaksanaan ujian, juga jimat reagent.

hbA1c ni memang dah stabil ikatan nya dengan hemoglobin darah, dipanggil Glycohemoglobin, maka setakat simpan untuk kumpul 3-4 hari, tidak menjejaskan keputusanya.

result hbA1c, hanya untuk monitoring sahaja! bukan confirmation.
kalau patient dtg dlm keadaan hypoglisemia atau hyperglycemia, lebih baik dijalankan RBS secara STAT.

saya pun mlt biasa je en. intang, cuba la rujuk pada FMS tentang keperluan ujian hbA1c ni.

saya setuju 100%!

Kita kena terima realiti. HbA1c boleh diminta oleh doktor sebagai ujian stat/urgent. Ini bergantung kepada kebijaksanaan sesaorang doktor menguna keputusan HbA1c itu.

Contohnya:http://www.japi.org/december2006/CR-953.htm

".............He was subjected to urgent HbA1c test to rule out repeated episodes of asymptomatic hypoglycemia......

wan......Betulkah HbA1c untuk "monitoring" sahaja?

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HbA1c Diagnostic Technique Proposed For Diabetes

By Daniel H. Rasolt

Posted: Wednesday, May 28, 2008

A panel of diabetes experts has recently made recommendations for the improved testing and diagnosing of the disease. It's estimated that over six million Americans suffering from diabetes don't know they have it, making the panel's recommendations an important step in better identifying the presence of this under-diagnosed condition.

In the United States, approximately 21 million people suffer from diabetes, making nearly one-third undiagnosed (the 6 million mentioned above). And for those that are diagnosed, the "average lag between onset and diagnosis is 7 years." This means that many diagnosed individuals are already in developed or severe stages of conditions like retinopathy, and are at high risk for diabetic-associated conditions like cardiovascular disease. While diabetes appears in different forms (varying degrees of severity in both type 1 and type 2 diabetes), it's become evident that improvements are necessary in both awareness and diagnostic techniques.

The panel that made the following recommendations consisted of "experts in the area of diagnosis, monitoring and management of diabetes." The underlying novel concept implemented by the panel was the use of hemoglobin A1c (HbA1c) as a diagnostic tool that measures blood glucose levels.

Before making specific recommendations, the panel considered the various benefits for using HbA1c over other blood glucose tests. They are as follows:

a) HbA1c does not require patients to be fasting;
b) HbA1c reflects longer term glycemia than does plasma glucose;
c) HbA1claboratory methods are now well standardized and reliable;
d) errors caused by non-glycemic factors affecting HbA1c such as hemoglobinopathies are infrequent and can be minimized by confirming the diagnosis of diabetes with a plasma glucose (PG)-specific test."

The two current blood glucose tests, fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT), both require approximately eight hours of fasting before administration. Also, HbA1c does not falter due to short-term lifestyle changes, whereas "a few days or weeks of dieting or increased exercise in preparation for a doctor visit can significantly affect FPG and OGTT."

The panel makes three specific diagnostic recommendations as to the use of HbA1C. The first states that "Screening standards should be established that prompt further testing and closer follow up." These include conditions being met such as HbA1c >6% during diagnosis. The second recommendation, which aims to establish a definitive definition of the presence of diabetes, states that "HbA1c ≥ 6.5 � 6.9%, confirmed by a PG-specific test (FPG or OGTT), should establish the diagnosis of diabetes." The third and final recommendation, which also aims to establish a definition of diabetes presence, states that "HbA1c ≥7%, confirmed by another HbA1c or a PG-specific test (FPG or OGTT) should establish the diagnosis of diabetes."

The suggested greater efficiency and safety of using HbA1c as a diagnostic tool for diabetes makes the recommendations of this study potentially profound. If doctors can begin to implement HbA1c, either in conjunction with FPG or OGTT, or confidently by itself, many undiagnosed diabetics may find out the possibly fatal condition they are living with. Six million people in America alone living with diabetes and not knowing it is tragic, but can be changed through greater awareness of the disease, and better diagnostic techniques.

agreed with U intang....
for diagnostic purpose to those who try cheating the test by well diet and control sugar intake before see the Dr...... esp when do med checkup for recontract!!!!

for stat cases no arguement such a cases.......TQ intang!!!

Intang wrote:Kita kena terima realiti. HbA1c boleh diminta oleh
doktor sebagai ujian stat/urgent. Ini bergantung kepada kebijaksanaan
sesaorang doktor menguna keputusan HbA1c itu.

Contohnya:http://www.japi.org/december2006/CR-953.htm

".............He was subjected to urgent HbA1c test to rule out repeated episodes of asymptomatic hypoglycemia......

i always found the farmacist will give acall to Dr when they quiry about drug was prescribe....and they overcome with a good point the option is the best for patient....my wonder why we never do same thing...is it cause our mind also behave too inferior as well!!!!

msaa wrote:....my wonder why we never do same thing...is it cause our mind also behave too inferior as well!!!!

maaf mengganggu perbincangan ilmiah ko rang.

Inferiority complex is not simple to overcome. Its hard to tackle. Also difficult to understand. Some said superiority also is a bad habit........So.......kita dituntut agar bersederhana dlm semua segi.

Wasallam

intang copy paste:

'The panel makes three specific diagnostic recommendations as to the use of HbA1C. The first states that "Screening standards should be established that prompt further testing and closer follow up." These include conditions being met such as HbA1c >6% during diagnosis. The second recommendation, which aims to establish a definitive definition of the presence of diabetes, states that "HbA1c ≥ 6.5 � 6.9%, confirmed by a PG-specific test (FPG or OGTT), should establish the diagnosis of diabetes." The third and final recommendation, which also aims to establish a definition of diabetes presence, states that "HbA1c ≥7%, confirmed by another HbA1c or a PG-specific test (FPG or OGTT) should establish the diagnosis of diabetes."

ayat ini mencadangkan HbA1c diterima sebagai salah satu diagnostic tools untuk kesan dan confirm diabetic pada patient.

buat pengetahuan en intang, kita x boleh sama sekali hanya mengambil 'satu' sumber dari internet, yg boleh dipertikaikan kesahihannya, dan buat seolah2 ia arahan standard. cuba search dan cari byk artikel lagi. dan compare.

dari segi standard ilmu peringkat universiti pun, satu artikel tidak boleh dijadikan panduan, kita sendiri kena kaji, bukan plagiat dan terima bulat2.

msaa wrote:agreed with U intang....
for diagnostic purpose to those who try cheating the test by well diet and control sugar intake before see the Dr...... esp when do med checkup for recontract!!!!

pahamkan ayat ni dulu.. nak diagnostic patient cheating, itu u punya pasal la arrange appointment dengan patient, bukan hantar lab dan stat, semata2 nak tahu patient u menipu atau x..

bagi PPP yg berminat mengetahui tentang HbA1c, terlebih dahulu rujuk pegawai anda.. iaitu MO tentang CPG di malaysia..

ini la akibatnya bila kita tiada truly medical xpert in lab such as head of laboratory deparment yg betul2 pakar dan merangka prossedur standard setiap ujian berdasarkan populasi dan budget di Malaysia, bukan ambik artikel sape tulis entah, pastu populasi di Amerika pulak tu..

jika en intang betul2 berminat dalam hal ini, cuba establish satu kes study, tentang keperluan hbA1c pro and contra untuk STAT atau tidak. pastu dapatkan pengesahan dengan badan profesional bertauliah, (then baru kita terima itu sebagai standard di Malaysia atau tidak), berdasarkan populasi dan ekonomi di Malaysia.

jika tidak semua MLT di Malaysia akan membuat keputusan ape yg mereka rasa betul. masalahnya, setiap org akan merasakan hujah mereka betul berdasarkan sumber yg mereka perolehi dn keadaaan logistik mereka. perlu ditekankan, di sarawak byk faktor logistik pesakit kita kena amik kira, tapi di semenanjung lain.. x payah nak tunjuk siapa menang atau kalah la..

[quote="Intang"]wan......Betulkah HbA1c untuk "monitoring" sahaja?

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monitoring purpose di pakai di malaysia saje. kat luar negara nak pakai tuk pe pun xpe la.. tu standard diorg. standard kita nak confirm diabetes pun

1. FBS > 7.0 mmol/L (2kali)
2. 2HPP atau MGTT > 11 mmol/L.

mana de termasuk hbA1c, tetapi kalau massa atau intang pergi seminar atau kursus terbaru tentang diagnostic patient diabetes di Malaysia termasuk HbA1c. boleh la share di sini.

zaki78 wrote:saya setuju 100%!

tQ zaki.. ade sesetengah org mementingkan ego dari fakta..
terima kasih kerana menerima fakta.

betol ckap kak wan......

cuba bayangkan cost untuk menjalankan ujian HbA1c,
1 kotak reagent = RM2,020.00
1 kotak QC normal = RM 300.00
1 kotak QC Abnormal = RM 300.00

dlm 1 kotak QC nie bukan byk pn adelah 3 btl, bt dilution 3ml.Bl nak wat test kena run QC dl, so leh la bayangkan kalu nak run stat...Alahai membazirnye........

tempat saya stat2 HbA1c ni x dilayan.
Bajet kt kat kesihatan bukan le besar sangat....
Bila dah abis kt gak yang pening byk oder pending...
program x jalan kt gak yang salah, sume tunding jari bilang "lab xde reagent, xleh bt".

[quote="msaa"]agreed with U intang....
for diagnostic purpose to those who try cheating the test by well diet and control sugar intake before see the Dr...... esp when do med checkup for recontract!!!!

for stat cases no arguement such a cases.......TQ intang!!!
[quote="Intang"]Kita kena terima realiti. HbA1c boleh diminta oleh
doktor sebagai ujian stat/urgent. Ini bergantung kepada kebijaksanaan
sesaorang doktor menguna keputusan HbA1c itu.

http://www.sciencedaily.com/releases/2008/05/080527084249.htm

I get your message and I understand you.

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