Overview
Boston Heart Prediabetes Assessment ® Test
Diabetes and prediabetes are major risk factors for heart disease and stroke. The U.S. Centers for Disease Control and Prevention estimates that about 70% of diabetics will eventually die of heart disease and about 15% from stroke. The number of Americans with diabetes and prediabetes is increasing; the American Heart Association recently identified that 38% of adult Americans in 2010 are prediabetic.
The Boston Heart Prediabetes Assessment helps healthcare providers identify patients at higher risk of developing diabetes, with 92% accuracy. Healthcare providers can prescribe interventions to patients at borderline or high risk for diabetes to significantly decrease the rate of onset of the disease.* Studies have proven a structured lifestyle program, like the Boston Heart Lifestyle Program, that includes weight loss and exercise, can reduce the risk of developing diabetes by 58% compared to usual care.*
*Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403.
Test Details
Boston Heart Prediabetes Assessment ® Test
A method of predicting the risk of developing diabetes (fasting serum glucose > 125 mg/dL) in subjects with prediabetes (fasting serum glucose 100 – 125 mg/dL). This method uses information about the person’s height, weight, parental history of diabetes, and use of cholesterol lowering medications (statins and niacin) along with the following measurements: fasting glucose, glycated serum protein, adiponectin, and triglycerides. This method provides a highly accurate assessment of the 10 year diabetes risk (over 92% accurate).
Methodology
Refer to individual assays for more detailed information.
- Turbidimetric
- Colorimetric
- Enzymatic
Patient Preparation
9 hour fast prior to collection. Patient may drink water only.
Preferred Specimen
1.0 mL serum (0.5 mL minimum) collected in a serum separator tube (SST/Tiger Top)
Alternative Specimen
N/A
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
Refrigerated: 3 days
Lab Values
Boston Heart Prediabetes Assessment ® Test
Prediabetes Assessment of the 10 year diabetes risk
- Low: <10%
- Borderline: 10 – 20%
- Increased Risk: >20%
Clinical Significance
Boston Heart Prediabetes Assessment ® Test
The Boston Heart Prediabetes Assessment® predicts the risk of developing diabetes in subjects with prediabetes with higher accuracy than other methods. The parameters used are fasting glucose, body mass index, glycated serum protein, adiponectin, parental history of diabetes, fasting triglycerides and use of cholesterol lowering medication. All are required to obtain a c-statistic of 0.92.1-4
- 70% of diabetics die of heart disease and 15% from stroke.5
- A structured lifestyle program, like the Boston Heart Lifestyle Program that includes weight loss and exercise can reduce the risk of developing diabetes by 58% compared to usual care.6
References:
- Schaefer EJ, White CC AIM, Otokozawa S, Horvath K, Asztalos BF, Wilson PW, Cupples LA. A new model for the prediction of diabetes mellitus; results from the Framingham Off spring Study (manuscript in preparation).
- Kolberg JA Jorgensen T, Gerwien RW, et al. Development of a type 2 diabetes risk model from a panel of serum biomarkers from the Inter99 cohort. Diabetes Care.
2009;32(7):1207-1212. - Lyssenko V, Jorgensen T, Gerwien RW, et al. Validation of a multi-marker model for the prediction of incident type 2 diabetes mellitus: combined results of the Inter99 and Botnia studies. Diab Vasc Dis Res. 2012;9(1):59-67.
- Noble D, Mathur R, Dent T, Meads C, Greenhalgh T. Risk models and scores for type 2 diabetes: systematic review. BMJ. 2011;343:d7163.
- Centers for Disease Control and Prevention. National daibetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
- Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
Treatment Options
Boston Heart Prediabetes Assessment ® Test
- Lifestyle Modification (diet, exercise and weight loss)
- Glucose stabilizing and/or insulin sensitizing medications
