fasting

Top 4 blog posts from 2017

by Kem Snavely Frost on February 8, 2018

Here’s a look back on our top four blog posts of 2017. As our industry continues to evolve, will these be the same topics top of mind this year, or will there be totally new trends for 2018? Follow our blog as we discover and address them this year. We are excited to learn more together!

 

4. Identifying potential health risks in the insurance industry
Six trends that could change the life insurance risk landscape. Read more

 

3. Score applicants in real-time using health-based data
The launch of Risk Identifier™ combines clinical laboratory history and prescription history to provide underwriters an applicant-level score. Read more

 

 

2. Improved fasting guidelines
By improving our fasting guideline recommendations, applicants have the choice of more appointment times. Read more

 

1. Illicit drug use on the rise
With more American workers testing positive for illicit drug use than they have in the past 12 years, how can insurers detect this and protect their bottom line? Read more

Knowing the value of improved fasting guidelines

by ExamOne on February 13, 2017

In our continued effort to improve the applicant experience while adhering to the latest medical standards, we have updated our fasting guidelines for life insurance exams. Our recommendation to clients and applicants is that fasting is no longer necessary before a life insurance blood or urine collection. This recommendation is based on evidence that shows the minimal impact that fasting plays on the standard life insurance laboratory panels. This update not only allows greater flexibility for applicants to complete exams throughout the day, it also follows the medical community’s guidelines for fasting.

Historically, the insurance industry required fasting because it was believed to produce more accurate glucose and lipid tests. When we switched to A1c testing on all specimens in 2016, this eliminated the need for fasting because A1c is not impacted by a recent meal, as glucose is a more reliable determination of long-term glucose control. Additionally, clinical research as well as our own internal fasting studies show that triglyceride is the only other analyte affected by a recent meal. Armed with the “hours fasted” information, underwriters can make a sound decision on each applicant.

For any additional clinical support of this recommendation, see below references and sources.

“Fasting times showed little association with lipid subclass levels in a community-based population, which suggests that fasting for routine lipid levels is largely unnecessary.”

Source: Davinder Sidhu, Christopher Naugler. Fasting Time and Lipid Levels in a Community-Based Population.  Archives of Internal Medicine. 2012; 172(22): 1707-1710.

“The exceedingly small gain of information from a fasting blood test likely does not offset the logistical constraints put on patients, laboratories, and doctors for the procedure.”

Source: (Editorial) Dr. J. Michael Gaziano. Comparison of a Novel Method vs the Friedewald Equation for Estimating Low-Density Lipoprotein Cholesterol Levels From the standard Lipid Profile.  Archives of Internal Medicine. 2012; 172(22): 1705-1706.

“Most lipid levels differed minimally when measurements were performed nonfasting or fasting, with clinically insignificant changes; negligible changes for high-density lipoprotein (HDL) cholesterol, slight changes (up to 8 mg/dL) for total cholesterol, LDL cholesterol, and non-HDL cholesterol; and modest changes (up to 25mg/dL) for triglycerides.”

Source: Samia Mora. Nonfasting for Routine Lipid Testing From Evidence to Action. JAMA Internal Medicine. July 2016; Volume 176 Number 7, 1005.

“Lipid levels at most change minimally in response to normal food intake in individuals in the general population. Furthermore, nonfasting lipid profiles predicted increased risk of cardiovascular events.”

Source: Ann Langsted, Jacob J. Freiberg, Borge G. Nordestgaard. Fasting and Nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation. 2008; 118: 2047-2056.

“Measurements of hemoglobin A1c [HbA1c] more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose.”

Source: Hemoglobin A1c Outperforms Fasting Glucose for Risk Prediction. John Hopkins Bloomberg School of Public Health , JHSPH.edu,. March 4, 2010. http://www.jhsph.edu/news/news-releases/2010/selvin-blood-test.html?source%3Drss

For additional support for this decision, please see our “To Fast or Not to Fast” white paper or contact Betsy Sears, Executive Vice President, Laboratory Strategy and Sales, at Betsy.R.Sears@ExamOne.com, or Dr. Jim Palmier, Medical Director at James.A.Palmier@ExamOne.com with additional questions.


This does not change any specific carrier fasting guidelines. 

 

Ask The Experts: Fasting and Specimen Transport

July 27, 2015 Ask The Experts

If an applicant does not fast before an exam, how will this impact their laboratory results? The only two results that will be impacted are triglycerides and glucose. Within three hours glucose should be normal; within eight hours triglycerides should be normal. What is the effect of a delayed specimen transport (from the time the […]

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Not so “fast”

March 22, 2013 Carriers

For as long as we can remember, the clinical standard has stressed the importance of fasting to receive accurate laboratory results. Fasting is still the Gold Standard and should be followed if at all possible. However, recent studies are now showing that only a minimal change will be reflected in the lipid panels with varied […]

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