Some doctors here are pushing for a convenient test, normally used to monitor blood sugar levels of diabetics, to help diagnose new cases.
 
From this month, just such a test kit which does not need patients to fast for hours beforehand will be available at clinics under the SingHealth Delivering-On-Target (Dot) programme - a multi-pronged approach to managing chronic conditions.

The test, taken once in three months by diabetics, shows the average amount of sugar in the blood over the last three months.

As blood cells are replaced once every two to three months, the test has to be retaken once every three months and the results will indicate if the blood sugar level is under control.

Diabetics will have an average blood sugar level of above 7 per cent.

Currently, a patient being screened for diabetes is tested for blood sugar levels after he has fasted for at least eight hours or overnight. This ensures that his system is 'clean' of any sugar prior to the test.

In the new 'no fast, no bother' test, blood is drawn from a pin-prick on a finger and the kit then measures the level of HbA1c, giving the test result within five to 20 minutes.

The blood test is currently either sent to a laboratory, or it is done on the spot at some hospitals and clinics.

HbA1c is the sugar molecule that is chemically attached to the haemoglobin in the blood.

Doctors feel the HbA1c test is currently one of the best ways to diagnose diabetes because it gives a more accurate reading of blood sugar levels.

A study last year, led by eye doctors at the Singapore Eye Research Institute, showed that this test was more accurate than the conventional tests in predicting complications such as blindness and kidney failure.

Also, an average HbA1c level taken over time has less variation than a one-off test.

Diabetes mellitus is a long-term illness characterised by high sugar levels in the blood. Sufferers either produce too little insulin to process the sugar or are unable to respond well to the insulin produced.

According to 2007 figures, the prevalence of diabetes mellitus among Singapore adults up to age 69 was 4.6 per cent.

Associate Professor Tai E Shyong, a clinician scientist with SingHealth, said the new method of diagnosis makes screening more convenient for patients.

However, endocrinologist Lee Chung Horn cautioned that until the recommendations are accepted, there is as yet no international standard on the use of the alternative test. Until then, fasting in order to test one's glucose level is still the standard method for diagnosis, he said.