Position statements - 13 August 2008

Diabetes Australia – Vic (DA–Vic) does not undertake nor advocate community-based random blood glucose testing such as finger prick tests as a screening method for diabetes. DA–Vic strongly recommends that these activities not be undertaken in the community as part of diabetes awareness programs.

RATIONALE

This position is supported by the Australian Diabetes Educators Association 1 and the American Diabetes Association 2, and is consistent with the National Health & Medical Research Council Guidelines 3

The position has been adopted by DA–Vic on the basis of the following:

• Community-based blood glucose screening is not diagnostic. Blood glucose readings obtained through random capillary sampling may be misinterpreted, and there is no opportunity for appropriate follow-up. Diagnosis can only be made on the basis of a plasma glucose test at a pathology laboratory or using point of care testing with an approved analyser with appropriate
  quality assurance. A fasting sample is preferred.
• Use of blood glucose meters for screening or diagnosis is not appropriate
• Outcomes of random community-based tests are influenced by a range of variables, such as operator skill, equipment used, type of food previously consumed, etc
• There is a risk of needle stick injury and transmission of blood-borne viruses
• Community blood glucose testing/screening is not cost-effective
• Blood glucose testing does not promote risk reduction
• It is inappropriate to test for diabetes, and for people to be informed of the outcome or its potential implications, in a public place.

RECOMMENDED COMMUNITY BASED ACTIVITIES

Diabetes Australia – Vic recommends that community-based activities incorporate:

• Promotion of awareness of risk factors and symptoms of type 2 diabetes
• Non–invasive risk assessment methods based on the known risk factors (as specified by appropriate guidelines 3) through use of questionnaires or similar eg the AUSDRISK4 test or the
  Life! Risk Assessment Test
• Referral of individuals identified as being at high risk to their general practitioner for appropriatefollow-up, including clinical screening if appropriate or alternatively as part of a co-ordinated program, point of care testing using appropriate analysers with appropriate quality assurance and access to counselling
• Promotion of lifestyle change to address risk factors that can be modified, including weight reduction, increased physical activity and healthy eating.

FURTHER INFORMATION
For further information please contact Diabetes Australia – Vic:
Phone: 9667 1777 or toll free 1300 136 588
Email: mail@diabetesvic.org.au

1. Australian Diabetes Educators Association (ADEA) Use of BG meters, 2005. Available on ADEA web site:
   www.adea.com.au
2. American Diabetes Association Position Statement, Screening for Type 2 Diabetes. Diabetes Care 26 (Suppl), S21-S23, Jan 2003.
3. NH&MRC National Evidence Based Guidelines for the Management of Type 2 Diabetes Mellitus: Primary Prevention,
   Case Detection and Diagnosis December 2001.
4. The Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). COAG Diabetes Reducing the risk of type 2
   diabetes initiative, Australian Government Dept of Health & Ageing 2008.

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