American Association for Clinical Chemistry
Better health through laboratory medicine
NACB News and Views

CME Credit Available for E-Learning Program on Diabetes Testing

 

This fall AACC and NACB introduced the Laboratory Support for Diabetes Testing certificate program. NACB Fellow William E. Winter, MD at the University of Florida chaired the program and led other faculty members in its completion.

This 8-course online educational program is for laboratory professionals who have a working knowledge of current theory and practice of diabetes testing, and who wish to improve their knowledge and competence in the newest principles and techniques. Those who will most benefit from completing this program include laboratory managers and supervisors; senior clinical laboratory scientists, industry scientists, physicians, and other mid- to senior-level laboratory professionals. Upon completion of the program, participants will receive a certificate of completion and continuing education credits.

 

To learn more about this certificate program, visit the program website.

Dr. Winter answered a number of questions for us about the program and diabetes. The remainder of this article reflects his responses to those questions. Thank you, Dr. Winter, for your significant contributions to this article.

The eight topics (for the eight courses in the program) reflect a physician's and a laboratorian's approach to a clinical problem. The first step in the clinical care of the patient is to appreciate their chief complaint in light of their history and physical examination. In the case of diabetes, the findings of polyuria and polydipsia can suggest the diagnosis of diabetes (e.g., the definition of diabetes). Once diabetes is considered and diagnosed (e.g., the clinical and biochemical diagnosis of diabetes), the specific type of diabetes must be discerned as different types of diabetes can have very different therapies (e.g., the classification and etiologies of diabetes). Once therapy is initiated, the success of the therapy must be monitored (e.g., the laboratory evaluation of long-term glucose control). A major complication of the diabetes is the development of nephropathy. The lab plays the predominant  diagnostic role in the detection of nephropathy (e.g., the laboratory evaluation of renal function in diabetes). Especially in people with type 1 diabetes, poor glycemic control, infection, trauma or other stresses can precipitate diabetic ketoacidosis. The laboratorian must understand the pathophysiology of this life-threatening condition in order to select appropriate testing (e.g., evaluation of ketosis in diabetes). The central lab does play a major role in the management of people with diabetes. However, possibly even more important, is self-monitoring of blood glucose that can allow the insulin-treated patient to better manage their blood glucose levels (e.g., point-of-care testing in diabetes). With the diagnosis of diabetes established, the greatest challenge is the daily management of diabetes that seeks to achieve and maintain near-normal glucose levels to prevent or delay the onset of diabetic complications (e.g., the clinical management of diabetes).

The laboratorian that completes this series of courses will be well versed in the modern diagnosis, monitoring and management of diabetes. This can ultimately provide better care to patients.

 The faculty of this program were chosen based upon their expertise and their talents as educators. James Nichols, PhD has authored a book on point-of-care testing and led the development of the AACC-NACB guidelines on point-of-care testing. Jim is internationally recognized as a leader and researcher in point-of-care testing. Randie Little, MD, is the director of the National Glycohemoglobin Standardization Program (NSGP). Who could lead a better discussion of hemoglobin A1c testing?

Desmond Schatz, MD is a pediatric endocrinologist. Desmond is an expert in the diagnosis, classification and treatment of diabetes. As well, Desmond is an internationally known researcher who is developing novel therapies for the treatment of new-onset type 1 diabetes and the prevention of type 1 diabetes.

In the wake of the obesity crisis, why is diabetes education is more important than ever before? “Obesity is fast outstripping tobacco use as the leading cause of preventable illness in the United States and other westernized countries. The demand for diagnostic and monitoring laboratory services will continue to escalate. Therefore the laboratorian will increasingly be involved in the care of people with diabetes.”

While most people know that diabetes is a serious condition, few people in the general population appreciate the very high morbidity and premature mortality caused by diabetes. With the explosion of severe obesity in children and youth, some health care experts have predicted that the current generation of young people may not live as long as their parents.

To be an effective laboratorian, you must interact with your clients. Your clients are the physicians, diabetes educators, nurses, physician's assistants and dieticians that all play a role in the care of the diabetic patient. Do not be afraid to take a leadership role. Have you introduced eAG reporting into your reporting system for Hb A1c measurements?

Keep up to date by being aware of diabetes issues by visiting the AACC and the ADA websites. Finally, regular continuing education, as provided by this certificate program, is vital to your role as a member of the health care team.

Click here to watch a video of Dr. Winter discussing this certificate program.