IMMUNOLOGIC & GENETIC TESTING IN DIABETES
Immunologic
Genetic

THE ROLE OF GLUCOSE MANAGEMENT IN DIABETES

NON & MINIMALLY INVASIVE GLUCOSE ANALYSIS

KETONES

GLYCATED PROTEINS

INSULIN & PRECURSORS, LEPTIN & AMYLIN: IS THERE A ROLE?

TESTING FOR MICRO ALBUMINURIA

Guidelines & Recommendations for Laboratory Analysis in the Diagnosis & Management of Diabetes Mellitus

Laboratory Medicine Practice Guidelines (LMPG) on Diabetes (1st Draft)

INTRODUCTION
One of the major efforts of NACB for the past 7 years has been development of Laboratory Medicine Practice Guidelines (formerly called Standards of Laboratory Practice, or SOLP’s). These represent consensus guidelines for the use of laboratory tests in the diagnosis and management of clinical problems. They also present goals for laboratory performance based on clinical needs. Originally conceived by Larry Kaplan, Ph.D., and adopted by the Board of Directors, the LMPG process is designed to unite clinicians and laboratorians to advance the discipline of clinical laboratory science and improve patient care. The first LMPG monograph on Nutrition was published in 1996, followed by monographs on Thyroid Disease, Neonatal Monitoring, Therapeutic Drug Monitoring, and Cardiac Markers. Two other LMPG monographs, on Hepatitis and Tumor Markers, are in the final stages of preparation.

While the LMPG process has always included both clinicians and laboratorians, until 1999 publications went primarily to laboratorians, with proceedings of the meetings being published in Clinical Chemistry. The Cardiac Marker LMPG has involved close cooperation between cardiologists and emergency medicine physicians, and Editorials on the Guidelines were published in cardiology and emergency medicine journals to coincide with the publication of the proceedings in Clinical Chemistry. The next two LMPG's, on Hepatitis and Diabetes, are to be reviewed and, ultimately, co-published with the appropriate clinical specialty society. In addition you should note on this Web Site a call for comments to update the Thyroid LMPG which is being done in cooperation with the American Thyroid Association (ATA).  It is believed that the increased involvement of clinicians will lead to more widespread adoption of the guidelines and gain additional visibility and prestige for our organization.

As part of the LMPG process, the draft of the Diabetes guidelines will be presented to the American Diabetes Association and will be presented as an Edutrak at the AACC meeting in San Francisco. The one day program, on July 25, 2000, will focus on the analytes currently used in the diagnosis and management of patients with diabetes mellitus.  In addition, newer analytes and technologies that may have clinical value in the future will be considered.  The speakers are:

The morning session will focus on glucose, including self-monitoring and noninvasive measurements.  This topic will be followed by glycated hemoglobin, autoimmunity, urine proteins and the program will end with potentially important new analytes, such as amylin and leptin.  Each presentation will consist of a 15-20 minute summary of the proposed guidelines and the evidence used to establish these guidelines.  The presentation will be followed by 20-25 minutes for comments from the audience. A draft of the guidelines is available on this NACB web site.  Go to the section on.

The LMPG program continues to evolve as a means for promoting the science of laboratory medicine.  The 2001 LMPG, on Emergency Toxicology, is in the planning stage, and discussions are underway on the topic for the 2002 program. Members interested in participating in future efforts should contact the Chair of the Education and Scientific Affairs Committee, Bob Dufour.