The Tethys Diabetes Risk Test

The number of factors involved in type 2 diabetes makes it hard to talk about the risk of diabetes without talking about blood pressure and cholesterol in the same breath as blood glucose, LDL or HDL cholesterol, or insulin. The PreDx Diabetes Risk Score, created by Tethys Bioscience, applies that logic to the laboratory. This test measures seven biomarkers (chemical measurements of biological processes underlying type 2 diabetes) in order to calculate a single-value risk score for developing type 2 diabetes within five years. diaTribe requested to test the PreDx test and Tethys was kind enough to offer us four free tests. People who take this test are characterized into three groups: low risk, moderate risk, and high risk. Individuals with low risk have a Diabetes Risk Score less than 4.5; those with moderate risk have a score greater than 4.5 but less than 8.0; and people with a score greater than 8.0 are considered to be at high risk. The company determined the scale for the test by following a population of people over five years and comparing their rates of diabetes with their results on the various biomarkers included in the test.

We recruited a number of long-time friends of diaTribe, including Amy D. Baker, who leads this issue’s Test Drive. None of the participants had been diagnosed with either type 1 or type 2 diabetes at the time this article was written.

Finally, diaTribe is offering five free Tethys tests in this month’s giveaway!

amy baker’s experience with PreDx – background

Thus far, adults I know who have revealed to me their type 2 diagnoses have also been found to have high blood pressure, central adiposity (that means they have extra weight around their abdomen), high body mass indices (BMIs), and other such risk factors for metabolic and heart disease.

I would not have originally identified myself as at risk, but my bravado was cracked a little when a friend and I took the type 2 diabetes risk assessment published by the Finnish Diabetes Association. His score was lower than mine despite differences in BMI that I thought should have given me an edge. The fact that my father has been diagnosed with type 2 bumps me into a higher risk category, and I decided to stop leaning so hard on BMI and body shape as my leading indicators.

When diaTribe offered a select few of us a chance to take the PreDx test we jumped at it, each for our own reasons. In my case, I wanted to know if this should be higher on my list of things to worry about than it is currently. I am a professional woman in her mid forties raising a young child. Between my Blackberry and bath time there truly isn’t a lot of time to spare and I have stripped my life of all clutter and extraneous activities. This includes worrying about things I don’t need to. For the others, it was a combination of curiosity, age, ethnicity and awareness of the type 2 epidemic that drew them to it. One member of the group mentioned that he was nearly at the age at which his father had his first heart attack, adding that both his mother and brother had chronic high blood pressure.

existing tests for prediabetes

I knew from my work as a marketing consultant that there were three main ways you can currently test for pre-diabetes and they all have flaws.

Fasting glucose: Specific, convenient, but not sensitive. Essentially, this means that a glucose result between 100 – 125 mg/dl puts you firmly in the prediabetes camp, but there are many people who may still have good control of fasting glucose but poor control of glucose after meals, who would not be recognized using just this test.

Oral Glucose Tolerance Test (OGTT): Specific and sensitive, but inconvenient. In most cases a blood glucose level above 140 mg/dl will accurately let you know that you have impaired glucose tolerance. However, this test takes at least two hours to perform and possibly additional time to analyze the results.

A1c: Not specific, but sensitive and convenient. The test does not always accurately reflect glucose control particularly in recently diagnosed people. On the other hand, it is easily administered in the doctor’s office and results are readily available.

Despite the various flaws in each of these tests, when used collectively, they offer a much better picture of one’s glycemic control. At separate times I have had the first two tests but not the third, and was curious to know what was better about the PreDx test. My assumption was that any diabetes risk test has got to be more sensitive, specific, convenient and affordable to trump tests we have already.

I am delighted to report that the PreDx test covers all these bases with one exception – cost. It is sensitive, specific, convenient, and includes an added bonus of giving you information about your risk of developing diabetes in the next five years.

risk of type 2 diabetes

In my case, the test told me that my risk for type 2 diabetes was low and I went home convinced I should focus on health improvements for a host of other reasons. I am not sure I would have paid out of pocket for this test, or even that I would foot the bill at its current pricing (~$465) in five or 10 years. I would certainly take it again once insurance companies begin to cover it and the cost is diminished to the cost of my normal co-pay for lab tests.

There is a current debate over the usefulness of telling a person that they are at risk for type 2 diabetes. It is difficult to make the necessary lifestyle and dietary changes needed when faced with such a diagnosis – let alone a risk of developing it in five years. I find that knowledge provided by this test is a gift, and knowing that I can be proactive about something to which most people would have had to react should be seen as a gift as well.

But I like knowing that there is an easy way to rule out the possibility of getting an unannounced, asymptomatic and painless disease that causes long-term complications if left unmanaged. There are so many things we do NOT get to affect in our lives, that the chance to know what you’re up against and tackle it early seems like a worthwhile investment. If some of my risk factors change, I will be back in their lobby, asking for another.

who should take this test?

My colleagues with whom I shared this Test Drive experience had quite a bit of input in terms of ideal candidates for this test. Some believed that there probably wasn’t much use in doing this test if neither you nor your physician believes you could be at any increased risk for diabetes or prediabetes (e.g., no family history of diabetes, normal blood pressure, normal cholesterol, normal blood glucose, not overweight etc.). Interestingly, though, over 25% of Americans have high blood pressure, over one third have high cholesterol, and a whopping two thirds of Americans are overweight. So… if you don’t have any risk factors that is great! But if you do, our group thought that the test might be useful, especially if you have a family history and one of the other risk factors. People who have been diagnosed with the metabolic syndrome or with prediabetes would greatly benefit from the test as a concrete justification for implementing lifestyle changes.

what about insurance coverage?

We understand that the decision for an insurance company to cover a predictive test like this relies on the whether or not they think that investing in this test will save them money down the road. The only way to figure that out is to see how many people actually do take action once they know they are at increased risk for diabetes. The rationale here being that the earlier you take action, the healthier you remain, and the fewer medical procedures that insurance companies must pay for.

If you would like to learn more about the test, see tethysbio.com

Aside from providing sample PreDx Diabetes Risk Scores, Tethys Bioscience Inc. was not involved in the research, preparation, or publication of this article. PreDx™ is a trademark of Tethys Bioscience.