November is National Diabetes Month. Earlier this year we became the first laboratory in the insurance industry to update our insurance profile to include HbA1c (commonly referred to as A1c) testing for all life insurance applicants. By upgrading to this test, we will help insurers identify more applicants who are either diabetic or who may be in the pre-diabetic stage and not even be aware of it.

This segment of “Ask the Expert” is from our laboratory expert, Betsy Sears, Vice President Laboratory Strategy and Sales. Betsy explains the effects of diabetes on an individual’s body and why we decided to add A1c testing on all applicants.

What occurs physiologically in the body when one has diabetes?
The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body.

In type 1 diabetes, usually diagnosed in children and young adults, the body does not produce insulin.

In type 2 diabetes, your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time, it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels.

Why is A1c used as the standard for diabetes diagnosis?
A1c is considered the gold standard for diabetes diagnosis according to the American Diabetes Association. Additionally, screening with A1c alleviates the need for the applicant to fast in order to get accurate blood results. Not having to fast means the applicant has a wider choice of appointment times and the paramedical exam can be completed sooner. (Download our fasting white paper to learn more on how fasting won’t affect the results of an applicant’s paramedical exam.)

Is the A1c test affected by pre-analytic conditions such as heat and time?
No, A1c is stable for the life of the purple top at the lab–28 days. Because A1c testing is part of our routine risk assessment screen now, every specimen is tested upon arrival at the laboratory.

What is an acceptable A1c range?
A normal A1c test result is considered to be less than 5.7% of total hemoglobin. The table below demonstrates the percentage of screened applicants (ages 18-79 tested from February 2016 – July 2016) that showed elevated A1c results even in the presence of normal “traditional” reflex markers.


Are there any factors that could affect the interpretation of A1c test results?
Yes. Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss or hemolytic anemia) may falsely lower A1c test results. Causes of shortened erythrocyte lifetime include: hemolytic anemia or other hemolytic diseases, homozygous sickle cell trait, pregnancy, recent significant or chronic blood loss. Caution should be used when interpreting the A1c test results from patients with these conditions.

Do you see a high rate of non-disclosure among your applicants with diabetes?
Yes. In a recent study of ExamOne life insurance applicants from 2014 to 2016, an astounding 44% of applicants did not acknowledge they had diabetes. By running an A1c screen, these applicants were identified and underwriters were able to more accurately assess an applicant’s mortality risk based on their laboratory results. Additionally, it should be noted that more than 93% of applicants were found to be pre-diabetic with an A1c screen. There is a chance this population segment didn’t disclose their diabetes condition simply because they were not aware of it existing. The table below highlights more information.




Committed to Canada

by Jessica Wahaus on November 8, 2016

canada1ExamOne has been the life insurance industry’s laboratory for more than 40 years. Although based in the United States, ExamOne is proud of our extensive, yet still growing, Canadian presence.

In order to fulfill our commitment to the industry, we provide our international market with comprehensive testing and unmatched customer service. Our dedicated staff ensures fast turnaround times, accurate test results and regulatory compliance. Additionally, multilingual applicant materials are available at to help educate applicants of all backgrounds about the paramedical examination process.

“Not only is ExamOne a leading laboratory for the life insurance industry, but we also provide education to agents,” said Raj Nimkar, Director, Client Solutions and Sales Support. “In addition to continuing education presentations, we provide opportunities for agents to learn more about the exam and laboratory testing process one-on-one with our representatives.”

ExamOne is also committed to helping our clients spread the word about the importance of life insurance in the Canadian markets. The Canadian Life and Health Insurance Association found life insurance protects 22 million Canadians, leaving 20 percent of the population without coverage. However, according to LIMRA, 75 percent of Canadians say they would have difficulty with living expenses if the primary wage earner were to die. By committing to spread the word, we can help more families protect the ones they love.

“By helping each person understand the value of life insurance, we’re helping more and more families be protected from life’s uncertainties,” said Paul Walker, Director, Sales and Operations, Canada and International Business. “We’re committed to creating a positive experience for clients and their applicants to get more families covered.”

Stay connected with ExamOne in Canada by opting in to receive email updates and following our LinkedIn page.

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