BNP misleading in black patients
I read with interest your article highlighing the difference between BHS and NICE hypertension guidelines (Clinical, February 19). I was also interested to note that you had reproduced the NICE quick reference guide.
This appears to have an obvious error with respect to the diagnosis of 'pre-diabetes'.
Impaired glucose tolerance is diagnosed using the oral glucose tolerance test not a fasting plasma glucose. And the FPG value of 6.5mmol/L given by NICE is neither diagnostic for IGT nor impaired fasting glycaemia.
I have witnessed this guidance being
reproduced erroneously in prescibing meetings too. This is a direct error from the guidelines and not a typo.
With the recent emphasis in Pulse regarding the possible introduction of obesity monitoring into Q&O measures, the NSF for diabetes' declared
aim to reduce the incidence of type 2 diabetes, and the difficulty that these diagnostic terms pose for many GPs, I am surprised that all GPs have not
yet been issued with an official correction from NICE.
Dr JDG Fearn-Smith
According to WHO:
·Impaired glucose tolerance is a fasting blood sugar <7 and="" a="" two-hour="" blood="" sugar="" (as="" part="" of="" a="" glucose="" tolerance="" test)="" of="">7>
·Impaired fasting glycaemia is FBS =6.1 Ã7mmol/L.