Should you really be fasting before getting lipid profile test?


October 4, 2016

Today is World Diabetes Day. It is being observed to create awareness of diabetes, considered one of the fastest catching lifestyle diseases. On this day, the November Issue of Postgraduate Medicine Journal published an interesting finding when it comes to fasting to do lipid-profile test. Here is a snippet from the article.

“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,” lead author of the new paper, Dr Saleh Aldasouqi (Michigan State University College of Human Medicine, East Lansing) told Medscape Medical News. Dr Aldasouqi and coauthor Dr George Grunberger (Grunberger Diabetes Institute, Bloomfield Hills, MI), who is incoming president of the American Association of Clinical Endocrinologists, present a number of arguments in their article as to why they think fasting is no longer necessary.

They point to recent evidence suggesting there is little difference in LDL-cholesterol levels between tests done in fasted vs non fasted states and say that the two testing modes equally predict mortality. In addition, capturing postprandial triglyceride spikes may actually better predict cardiovascular risk ,they add. Moreover, they say, fasting is inconvenient and can even be dangerous, because of the risk for hypoglycemia in patients with type 1 diabetes and in those with type 2 diabetes who use insulin or sulfonylureas (Diabetes Care.2011;34:e52).

But on the other side of the debate are experts who argue that the entire literature addressing the link between lipid levels and cardiovascular risk is based on fasted values.

There aren’t yet enough data linking non-fasting values to cardiovascular outcomes to support changing practice, they argue. Moreover, doing so would introduce further variability than that exists already and an unacceptable lack of standardization.

Does your doctor/lab tell you to go through lipid test after fasting? What has been your experience? Please share your thoughts.

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