Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Is It Time to Eliminate the Need for Overnight Fasting for Lipid Tests in Patients With Diabetes?

Is It Time to Eliminate the Need for Overnight Fasting for Lipid Tests in Patients With Diabetes? We read with interest the recent study by Sidhu and Naugler.1 Corroborating the findings of several recent studies, this large cross-sectional study showed little association between fasting times and lipid subclass levels. The authors suggested that fasting for routine lipid levels is largely unnecessary. While this study1 underscores the futility and inconvenience of the “traditional requirement” for fasting for the purpose of lipid testing, we would like to take this opportunity to draw the attention of the medical community to a related safety issue within a vulnerable sector of the population, people with diabetes. Patients with diabetes represent a large proportion of the population in whom frequent blood lipid testing is routinely performed. A recent small study2 has found that such patients are at risk of hypoglycemia, if antidiabetic medications are not adjusted appropriately in preparation for overnight fasting. Such careful preparation is not usually followed, according to anecdotal observation in routine clinical settings. These patients are exposed to risk to themselves and others should hypoglycemia occur while en route to and from the laboratory facilities. We would like to commend the authors for this compelling and thought-provoking study,1 which challenges the deeply rooted belief of (prolonged fasting) being a prerequisite for lipid testing. At the same time, we would like to echo recent convincing arguments raised by some authors,3-5 in which they question if overnight fasting is, at all, needed for routine lipid testing. In our case, the concern is not merely about the inconvenience and utility of the routine overnight fasting in general, but it is about the additional risk of hypoglycemia in patients with diabetes.2,3 Therefore, we call on clinicians to refrain from routinely asking patients with diabetes to fast for lipid testing and limit fasting to the few patients whose clinical needs indeed require overnight fast. In the latter case, we recommend that extra care is taken to avoid hypoglycemia, including more frequent glucose monitoring and proper adjustment of antidiabetic medications. Back to top Article Information Correspondence: Dr Aldasouqi, Division of Endocrinology, Department of Medicine, Michigan State University College of Human Medicine, B-330 Clinical Center, 788 Service Rd, East Lansing, MI 48824 (saldasouqi@gmail.com). Conflict of Interest Disclosures: None reported. References 1. Sidhu D, Naugler C. Fasting time and lipid levels in a community-based population: a cross-sectional study. Arch Intern Med. 2012;172(22):1707-171023147400PubMedGoogle Scholar 2. Aldasouqi S, Sheikh A, Klosterman P, et al. Hypoglycemia in patients with diabetes on antidiabetic medications who fast for laboratory tests. Diabetes Care. 2011;34(5):e5221525492PubMedGoogle ScholarCrossref 3. Grunberger G. Do we need a fasting lipid profile to assess cardiovascular risk? J Diabetes. 2011;3(3):172-17321668658PubMedGoogle ScholarCrossref 4. Gaziano JM. Should we fast before we measure our lipids? Arch Intern Med. 2012;172(22):1705-170623401886PubMedGoogle ScholarCrossref 5. Khera A, Mora S. Fasting for lipid testing: is it worth the trouble? Arch Intern Med. 2012;172(22):1710-171223405395PubMedGoogle Scholar http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Is It Time to Eliminate the Need for Overnight Fasting for Lipid Tests in Patients With Diabetes?

Aldasouqi, Saleh A.; Grunberger, George
JAMA Internal Medicine , Volume 173 (10) – May 27, 2013
Download PDF
2 pages

Loading next page...
 
/lp/american-medical-association/is-it-time-to-eliminate-the-need-for-overnight-fasting-for-lipid-tests-RYgbVitCHP

References (8)

Publisher
American Medical Association
Copyright
Copyright © 2013 American Medical Association. All Rights Reserved.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.398
Publisher site
See Article on Publisher Site

Abstract

We read with interest the recent study by Sidhu and Naugler.1 Corroborating the findings of several recent studies, this large cross-sectional study showed little association between fasting times and lipid subclass levels. The authors suggested that fasting for routine lipid levels is largely unnecessary. While this study1 underscores the futility and inconvenience of the “traditional requirement” for fasting for the purpose of lipid testing, we would like to take this opportunity to draw the attention of the medical community to a related safety issue within a vulnerable sector of the population, people with diabetes. Patients with diabetes represent a large proportion of the population in whom frequent blood lipid testing is routinely performed. A recent small study2 has found that such patients are at risk of hypoglycemia, if antidiabetic medications are not adjusted appropriately in preparation for overnight fasting. Such careful preparation is not usually followed, according to anecdotal observation in routine clinical settings. These patients are exposed to risk to themselves and others should hypoglycemia occur while en route to and from the laboratory facilities. We would like to commend the authors for this compelling and thought-provoking study,1 which challenges the deeply rooted belief of (prolonged fasting) being a prerequisite for lipid testing. At the same time, we would like to echo recent convincing arguments raised by some authors,3-5 in which they question if overnight fasting is, at all, needed for routine lipid testing. In our case, the concern is not merely about the inconvenience and utility of the routine overnight fasting in general, but it is about the additional risk of hypoglycemia in patients with diabetes.2,3 Therefore, we call on clinicians to refrain from routinely asking patients with diabetes to fast for lipid testing and limit fasting to the few patients whose clinical needs indeed require overnight fast. In the latter case, we recommend that extra care is taken to avoid hypoglycemia, including more frequent glucose monitoring and proper adjustment of antidiabetic medications. Back to top Article Information Correspondence: Dr Aldasouqi, Division of Endocrinology, Department of Medicine, Michigan State University College of Human Medicine, B-330 Clinical Center, 788 Service Rd, East Lansing, MI 48824 (saldasouqi@gmail.com). Conflict of Interest Disclosures: None reported. References 1. Sidhu D, Naugler C. Fasting time and lipid levels in a community-based population: a cross-sectional study. Arch Intern Med. 2012;172(22):1707-171023147400PubMedGoogle Scholar 2. Aldasouqi S, Sheikh A, Klosterman P, et al. Hypoglycemia in patients with diabetes on antidiabetic medications who fast for laboratory tests. Diabetes Care. 2011;34(5):e5221525492PubMedGoogle ScholarCrossref 3. Grunberger G. Do we need a fasting lipid profile to assess cardiovascular risk? J Diabetes. 2011;3(3):172-17321668658PubMedGoogle ScholarCrossref 4. Gaziano JM. Should we fast before we measure our lipids? Arch Intern Med. 2012;172(22):1705-170623401886PubMedGoogle ScholarCrossref 5. Khera A, Mora S. Fasting for lipid testing: is it worth the trouble? Arch Intern Med. 2012;172(22):1710-171223405395PubMedGoogle Scholar

Journal

JAMA Internal Medicine – American Medical Association

Published: May 27, 2013

Keywords: diabetes mellitus,fasting,lipids

There are no references for this article.