Queen Elizabeth Hospital Birmingham (QEHB) is appealing for diabetics to volunteer for a vital study aimed at improving the accuracy of testing for the disease.

The simple blood test for haemoglobin A1c (HbA1c) is performed in hospital laboratories across the UK, which are the subject of quality control checks to ensure they provide accurate and reliable results.

The lab monitoring is carried out by Birmingham Quality, a department at QEHB. HbA1c cannot be made artificially and Birmingham Quality relies on diabetic blood donors to provide the blood samples required to undertake the quality control checks.

Recent changes to national guidelines have ruled out most of its existing diabetes volunteers. This is because the National Blood Service, which takes the samples on behalf of the hospital, is no longer able to take blood from insulin-dependent donors.

As a result, QEHB has been left with fewer than a dozen volunteer donors in the ongoing study compared to the 48 they were previously able to call upon.

The appeal for volunteers with type 2 diabetes comes as official figures reveal that a record 40 million prescriptions were made out for diabetes drugs last year – a rise of nearly 50 per cent in six years. This led to the cost of the disease to the NHS rising last year to £760 million.

There are 2.8 million diabetes sufferers in the UK, plus an additional 850,000 people who are unaware they have it. This compares with 1.9 million patients with diabetes in 2005/06.

Jane French, Consultant Clinical Scientist at QEHB, said: “Diabetes is one of the most serious health problems of our time. It’s essential that diabetes is diagnosed quickly and that once a diagnosis has been confirmed, patients are monitored regularly to ensure that they receive the best form of treatment to control their blood sugar levels.

“Diabetes is diagnosed and monitored using a simple blood test to measure glycated haemoglobin (HbA1c). This test is performed in hospital laboratories that participate in a special quality control service to help them provide accurate and reliable results.

“Our donors’ samples are taken by the National Blood Service, but they reviewed the criteria which all blood donors must meet in order to donate a unit of blood. One aspect of this is that we are now unable to call donors who are dependent on insulin to control their diabetes.

“We have previously been calling donors with type 1 and type 2 diabetes for the quality control programme. Most of our volunteer donors were using insulin but following the update to the national guidelines last year, we lost three quarters of our donors overnight. We now have a substantial shortage of diabetic blood donors able to participate in the study which is designed to improve the accuracy of the HbA1c test.

“The unfortunate thing is that many type 2 diabetics eventually end up on insulin so we need a rolling recruitment programme to replace those diabetics who eventually have to retire from our donor panel. We are now down to 11 donors and this means that every month we are living hand to mouth, even though all 11 are happy to give blood up to three times a year.

“We rely on them and couldn’t do it without them. Their generous donations of blood have made an enormous contribution to the quality of HbA1c blood test results across the UK and, indeed, all around the world.”

Birmingham Quality distributes around 400 samples from each unit of blood taken from its donors to all hospital laboratories in the UK and some in northern Europe.

Jane added: “We ask the participating laboratories to test the blood to make sure they are getting the right results. We send them three samples a month and look at their overall performance. If we have any concerns that a lab is outside the acceptable level we write to them, and they have to respond to us within a month.

“We input into a body called the National Quality Assurance Advisory Panel and we can report labs to them. It has the power to close a lab down, but in all my time it has never happened in a laboratory measuring HbA1c. That is why our programme is so valuable”

To join the QEHB programme you must:

• have type 2 diabetes which is not controlled using insulin
• be between the ages of 18 and 65
• be in good health apart from your diabetes
• be willing to donate one unit (about a pint) of blood once or twice a year

Patients included in the study will donate their blood at the National Blood Service Centre in Birmingham city centre, in exactly the same way as giving blood for transfusion. Patients will be given a comprehensive health assessment prior to being asked to donate blood for the programme as well as compensation for their travel.

For more information with no obligation, please call Jane French, Consultant Clinical Scientist at Queen Elizabeth Hospital Birmingham on 0121 414 7300.

Alternatively, please email Birmingham Quality with your details.

Email: BirminghamQuality@uhb.nhs.uk