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The haemoglobin HbA1C test (A-one-C test) which is listed as a benefit for National Health Fund (NHF) card members could play a greater role in identifying patients with undetected diabetes.

This is according to a study published in the July issue of the Journal of clinical Endocrinology and Metabolism which states that while the test is an effective measure of long-term glucose control, doctors don’t typically use it to screen for or diagnose the disease.

Last year, the National Health Fund (NHF) added the HbA1C test as an Individual Benefit not just for NHF diabetics who are subsidised two tests each year but also to persons attending NHF Community Health Days where the tests is offered for free. Since the intervention by the NHF, HbA1C monitoring is more widely used by medical practitioners as the NHFcard subsidy makes the cost more affordable to individuals.

Chief Executive Officer of NHF, Mr. Raphael Barrett, says that the result of the study is timely, as the NHF is now encouraging medical practitioners to recommend this screening method to their patients. The CEO says the benefits will go a far way in improving the efficient monitoring of glycemic control as well as improving the management and care of diabetic patients. This will substantially reduce the long-term complications and associated costs of diabetes which is a significant factor in individual productivity loss and high healthcare costs.

Dr Rosemarie Wright-Pascoe, President of the Medical Association of Jamaica and an Endocrinologist, noted that there has been a worldwide trend in attempting to make the procedure for diagnosing diabetes easier. She stated that studies have documented that at any one time, half the persons with diabetes in Jamaica are unaware that they have this disease.

She further noted that the news that the HbA1C test can now also be used to diagnose diabetes mellitus is a welcome one. She congratulated the NHF for unprecedented move last year in making this test available at a reasonable cost, not only for the monitoring of diabetes control in diabetics but now also for the screening of persons for diabetes mellitus.

“The introduction of the HbA1c test is a reflection of the seriousness with which the NHF views diabetes, a catastrophic disease which affects all systems of the body and increases the risk for other chronic diseases”, Mr. Cecil White, NHF Vice-President of Operations.

Executive Director of the Diabetes Association of Jamaica (DAJ), Owen Bernard, said that subsidy of the HbA1c test by the NHF is a major step in diabetes management which qualifies Jamaica as one of the worldwide leaders in this area. “The NHF HbA1c programme is one of the best things that have happened as it cushions the cost burden to those in need,” he said.

According to Mr. Bernard, there is a need for more of these tests to be carried out because many persons are unaware that they have the disease until complications such as eye problems manifest themselves. The test, he noted, forms part of the routine community outreach screening programme also sponsored by the NHF.

The test, which is considered the gold standard measurement in diabetes management, is used to monitor the blood glucose levels in diabetics and will assist over 60,000 diabetics registered with the NHFcard to improve their glycemic control and reduce the risk of diabetic complications such as cardiovascular and eye disease. All diabetics enrolled for the NHFcard are allowed two subsidised tests annually. The test is now available at more than 40 providers, islandwide, including hospitals, laboratories, doctors and other authorised medical facilities.

The DAJ has recently commenced using the test on its patients in Kingston. Its branches in Southfield, St. Elizabeth; Morant Bay, St. Thomas; Port Maria, St. Mary and Falmouth, Trelawny are also poised to offer the test.

Under its HbA1c test programme the NHF, in conjunction with the manufacturer of the equipment Axis-Shield of Norway, supplies providers with the testing instrument free of charge and also covers the cost of test kits and consumables with the NHFcard subsidy. This has resulted in the tests being more affordable thereby encouraging an increase in the frequency of tests done to improve the management and care of diabetics.

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