Incidental Finding of Sickle Cell Trait From an Everyday Diabetes Test: Should General Health Care Providers and testing centres report, retest, or refer?

Date

2019-09-17

Advisors

Journal Title

Journal ISSN

ISSN

0891-8929
1945-4953

Volume Title

Publisher

American Diabetes Association

Type

Article

Peer reviewed

Yes

Abstract

The HbA1c test is increasingly widely used as a diagnostic and screening test for diabetes mellitus type 2 (T2DM) but the presence of haemoglobin variants, such as sickle haemoglobin, can interfere with results in some analytical systems. These interferences are occasionally reported by laboratories, leading unprepared patients to suspect they may be sickle cell carriers and seek confirmation through a sickle cell test. Incidental findings of Hb variants, and the reporting thereof, present multiple ethical challenges to laboratories, medical practitioners, patients and their family members, but there appear to be no international or national guidelines on how to deal with the reporting of these findings. This paper explores issues such as whether informed consent is necessary, how the results should be communicated, how the patient may be affected by knowing their carrier status, the timing of communications, complications caused by partial results, and being a ‘healthy carrier’ at the same time as potentially experiencing symptoms.

Description

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

Keywords

sickle cell, genetic testing, diabetes, primary care, ethics

Citation

Cronin de Chavez, A., Dyson, S.M., Babbington, F., Berghs, M., Atkin, K.A., Whitelaw, D. and Miller, A. (2019) Incidental Finding of Sickle Cell Trait From an Everyday Diabetes Test: Should General Health Care Providers and testing centres report, retest, or refer? Clinical Diabetes

Rights

Research Institute

Institute for Allied Health Sciences Research