Fasting before getting your blood drawn for cholesterol tests is common practice.
But in the new research, researchers from Michigan State University found it is a contributing factor of low blood sugar, or hypoglycemia, in patients who take diabetes medications.
It shows that people with diabetes are more likely to experience FEEHD—fasting-evoked en route hypoglycemia in diabetes—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.
The team explained that eating before a lab test does not alter the results of the pivotal components of the cholesterol test as previously thought.
In fact, fasting for these tests can incite hypoglycemia in patients with diabetes.
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.
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.
The new motto from this study is ‘Feed not FEEHD’, to remind patients of this danger and get them to eat.
Hypoglycemia happens when blood sugar levels drop below 70 mg/dl and can cause faintness, confusion and even a loss of consciousness.
Severe hypoglycemia can cause acute harm to the patient or others, especially if it causes falls or motor vehicle accidents.
Routine fasting is based on guidelines from the 1970s and newer studies show it may not be necessary anymore.
Canada and Europe have already changed their guidelines and no longer require fasting for lipid tests, the most commonly ordered fasting labs.
Similar U.S. guidelines have not yet become mainstream. In view of the risk of FEEHD, 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.
It involved 525 patients with diabetes and was conducted at two endocrinology practices in Michigan.
Patients completed a two-page survey and were excluded if data were missing or they reported no fasting labs in the previous 12 months.
The researchers found that only 35% of patients surveyed indicated having received any FEEHD prevention instructions from their doctor prior to their lab visit.
The researchers 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.
The team aims to bring this problem to light and further educate doctors and patients about the consequences of fasting while on diabetes medications.
They plan to conduct a larger, population-based study to determine the prevalence of FEEHD in the general population.
The study is published in the International Journal of Endocrinology.
Copyright © 2018 Knowridge Science Report. All rights reserved.
Source: International Journal of Endocrinolog.
