A combined Medicare item number for a ‘care set’ of annual pathology tests may be one way of improving the management of adults with stable diabetes, according to the Royal College of Pathologists Australia (RCPA).

RCPA president Dr Michael Harrison said studies show there is significant under-monitoring of diabetes with up to half of patients missing out on important tests such as a yearly microalbumin or eGFR.

“We know that patients who are not managed to an appropriate target are at a higher risk of developing complications. HbA1c is usually checked more frequently but other tests are sometimes missed,” he said.

“For example, deteriorating renal function is a major cause of both morbidity and mortality and those tests are certainly not being done reliably enough.”

The care set outlined in a recent RCPA position statement and consistent with clinical guidelines, includes annual checks for:

• Creatinine, cholesterol, triglycerides (MBS item 66506)
• HDL cholesterol (MBS item 66536)
• Microalbumin (MBS item 66560)
• HbA1c (MBS item 66551)

“This care set is the first step to try to improve management of diabetes and reduce preventable complications. However we will also be lobbying for a combined item number as part of the MBS Review,” Dr Harrison said.

He said the care set may help with the considerable variation in requesting practices by GPs, however another concern was the many patients non compliant with pathology requests.

Australian Diabetes Society (ADS) president Professor Sophia Zoungas told the limbic the position statement would be reviewed by the ADS Medical Affairs Subcommittee.