Diabetics, be careful of fasting before lab tests

Fasting before getting blood drawn for cholesterol tests might contribute to low blood sugar, or hypoglycemia in diabetes patients, according to a new study.

The study, published in the International Journal of Endocrinology, demonstrates that diabetes patients are more likely to experience fasting-evoked en route hypoglycemia in diabetes (FEEHD) than they would if they hadn’t fasted. The "en route" comes from patients who have an episode while driving to a lab for blood work.

Saleh Aldasouqi, an endocrinologist in the College of Human Medicine, and colleagues explained that eating before the lab tests do not modify the results of cholesterol test's crucial components as previously thought. Rather, fasting before these tests can cause hypoglycemia in diabetes patients.

"Hypoglycemia is an overlooked problem that we see from time-to-time in patients with diabetes who show up for lab tests after skipping breakfast," Aldasouqi said. "Patients continue taking their diabetes medication but don't eat anything, resulting in low blood sugar levels that cause them to have a hypoglycemic event while driving to or from the lab, putting themselves and others at risk. Our new motto is 'Feed not FEEHD', to remind patients of this danger and get them to eat."

Hypoglycemia is characterized by blood sugar levels below 70 mg/dl. Symptoms include faintness, confusion and even a loss of consciousness. It can cause falls or motor vehicle accidents resulting in acute harm to the patients or others.

It involved the study of 525 diabetes patients and was conducted at two endocrinology practices in Michigan. Patients were asked to complete a two-page survey and were excluded in case of missing data or their reporting of no fasting labs in the previous 12 months.

Aldasouqi said that routine fasting is based off guidelines from the 1970s and newer studies show it may not be necessary anymore. Aldasouqi hopes for diabetes organizations to take a lead in disseminating these emerging changes on lipid testing.

The study showed proper education about fasting and diabetes also is lacking. Only 35 percent of patients surveyed indicated having received any FEEHD prevention instructions from their doctor prior to their lab visit.

"We encourage patients who receive orders for a lab test to ask their doctor if fasting is really necessary, and if so, how they should handle their diabetes medications during the fasting period to account for the changes in their blood sugar levels," Aldasouqi said. "FEEHD is overlooked in clinical practice, and we aim to bring this problem to light and further educate doctors and patients about the consequences of fasting while on diabetes medications."

Aldasouqi plans to conduct a larger, population-based study to determine the prevalence of FEEHD in the general population.

For further reference follow the link: https://doi.org/10.1155/2018/1528437