Medical Benefits Schedule lists HbA1c test for diagnosis of diabetes

From November 1 doctors are now able to use the HbA1c test to diagnose diabetes.

Previously the recommended method for the diagnosis of diabetes was by measuring fasting blood glucose and then following that up with an oral glucose tolerance test (OGTT) in those who were not clearly diabetic or non-diabetic on the fasting blood glucose results. Many patients require the oral glucose tolerance test and this is quite difficult for the patient to perform correctly. Two abnormal tests are required to confirm the diagnosis of diabetes. The OGTT requires a 3-day preparatory diet, overnight fasting and a 2-hour testing period. A significant number of people having an OGTT get quite nauseated and feel unwell after drinking the glucose solution.

In the past, HbA1c testing was only subsidised for monitoring blood glucose control in patients with established diabetes. Using the HbA1c test is much simpler for patients than the fasting glucose test or the OGTT. This is because the test does not require fasting and can be done at any time of day. The new MBS item allows the test to be done once per patient per year, with an HbA1c of ≥6.5% (48mmol/mol) required for a diagnosis.

The new test will not be suitable for a small number of patients with other illnesses including severe kidney and liver disease and certain blood disorders.



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