New research suggests that diabetes patients do not need to fast before lipid tests.
The study, published in Postgraduate Medicine, suggests that fasting and non-fasting tests showed little difference in terms of LDL-cholesterol levels. In addition, there is no difference in how they predict mortality.
The researchers also identified that fasting is potentially dangerous, increasing the risk of hypoglycemia in type 1 diabetes patients.
Dr Saleh Aldasouqi, of Michigan State University College of Human Medicine, and lead author of the study, said: “We would like doctors who treat patients with diabetes to ask, do I really need to fast my patient for this test? There is now strong and compelling evidence that in the case of the lipid-profile [test] perhaps we don’t need to fast our patients.”
Those on the other side of the debate claim that fasted values have been used for all the data concerning the link between lipid levels and cardiovascular risk. Making non-fasting tests equally valid would create too many variables and prevent standardisation.
Incoming president, medicine and science, of the American Diabetes Assocation Dr. Samuel E Dagogo-Jack said: “People are used to measuring many things in the fasted state. To superimpose an additional uncontrollable measure of random dietary patterns is going to make interpretation exceedingly difficult.”
Despite the arguments against this shift in standard practice, the approach to diabetes treatment is becoming increasingly individualised, with emphasis being placed on doctor-patient dialogues. Non-fasting tests may yet become an acceptable alternative.

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