Could there be 5 types of diabetes?

Could there be 5 types of diabetes?

A peer-reviewed study, published in The Lancet Medical Journal suggests there are five types of diabetes. Could diabetes be more complex than we once thought? Could diabetes be segmented into five separate diseases?

 

What is diabetes?

Diabetes is an incurable disease which prohibits the body’s ability to produce and respond to insulin.  Currently, diabetes is classified into two main forms, type 1 and type 2.

Type 1 diabetes is an autoimmune disease which manifests in childhood.  In type 1 diabetes, the body’s white blood cells attack the insulin-producing cells in the pancreas.  As a result, individuals with Type 1 diabetes rely on the injection of insulin for the remainder of their lives.

Type 1 diabetes affects 10 percent of individuals with diabetes.  96 percent of children diagnosed with diabetes have type 1.  Type 1 diabetes in children is commonly diagnosed between the ages of 10 and 14.  The prevalence of type 1 diabetes in children and young people (under the age of 19) is 1 in every 430-530 and the incidence of type 1 in children under 14 years of age is 24.5/100,000 (Diabetes UK, 2014).

Type 2 diabetes is the result of insulin resistance, meaning that the pancreas does not produce enough insulin or the body’s cells do not respond to the insulin produced.  As type 2 diabetes is a mixed condition, with varying degrees of severity, there are a few methods to manage the disease, including dietary control, medication and insulin injections.

Type 2 diabetes is the most common form of diabetes, affecting 90 percent of individuals with diabetes, and has now become a global burden.  The global prevalence of diabetes has almost doubled from 4.7 percent in 1980 to 8.5 percent in 2014, with a total of 422 million adults living with diabetes in 2014.  It is expected to rise to 592 million by 2035.  In 2012, diabetes accounted for 1.5 million deaths globally with hypertension causing a further 2.2 million deaths.  43 percent of these deaths occurred before 70 years of age.  Previously type 2 diabetes was commonly seen in young adults but is now commonly seen in children as well.  In 2017, 14% more children and teenagers in the UK were treated for diabetes compared to the year before (World Health Organization, 2016).

In both forms of diabetes, hyperglycemia can occur which can lead to number of associated complications including renal disease, cardiovascular disease, nerve damage and retinopathy.

 

The novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables – peer-review study

This new research studied 13,270 individuals from different demographic cohorts with newly diagnosed diabetes, taking into consideration body weight, blood sugar control and the presence of antibodies, in Sweden and Finland.

This peer-reviewed study identified 5 disease clusters of diabetes, which have significantly different patient characteristics and risk of diabetic complications.  The researchers also noted that the genetic associations in the clusters differed from those seen in traditional type 2 diabetes.

Cluster One – Severe autoimmune diabetes (SAID)

SAID is similar to type 1 diabetes.  SAID manifests in childhood, in patients with a low BMI, have poor blood sugar and metabolic control due to insulin deficiency and GADA.  6% of individuals studied in the ANDIS study were identified with having SAID.

Cluster Two – Severe insulin-deficient diabetes (SIDD)

SIDD is similar to SAID, however, GADA is negative.  This means that the characteristics of SIDD are the same as SAID, young, of a healthy weight and struggled to make insulin, however, SIDD is not the result of an autoimmune disorder as no autoantibodies are present.  Patients have a higher risk of diabetic retinopathy.  18% of subjects in the ANDIS study were identified with having SIDD.

Cluster Three – Severe insulin-resistant diabetes (SIRD)

SIRD is similar to that of type 2 diabetes and is characterised by insulin-resistance and a high BMI.  Patients with SIRD are the most insulin resistant and have a significantly higher risk of kidney disease, and microalbuminuria, and non-alcoholic fatty liver disease.  15% of subjects in the ANDIS study were identified as having SIRD.

Cluster Four – Mild obesity-related diabetes (MOD)

MOD is a mild form of diabetes which generally affects a younger age group. This is not characterised by insulin resistance but by obesity as their metabolic rates are close to normal.  22% of subjects in the ANDIS study were identified as having MOD.

Cluster Five – Mild age-related diabetes (MARD)

MARD is the most common form of diabetes manifesting later in life compared to the previous four clusters.  Patients with MARD have mild problems with glucose regulation, similar to MOD.  39% of subjects in the ANDIS study were identified with having MARD.

This new sub-classification of diabetes could potentially enable doctors to effectively diagnose diabetes earlier, through the characterisation of each cluster, including: BMI measurements, age, presence of autoantibodies, measuring HbA1c levels, ketoacidosis, and measuring fasting blood glucose levels.  This will enable a reduction in the incidence of diabetes complications and the early identification of associated complications, and so patient care can be tailored, thus improving healthcare (NHS, 2018) (The Week, 2018) (Ahlqvist, et al., 2018) (Collier, 2018) (Gallagher, 2018).

The Randox diabetes reagents cover the full spectrum of laboratory testing requirements from risk assessment, using our Adiponectin assay, to disease diagnosis and monitoring, using our HbA1c, glucose and fructosamine assays, to the monitoring of associated complications, using our albumin, beta-2 microglobulin, creatinine, cystatin c, d-3-hydroxybutyrate, microalbumin and NEFA assays.

Whilst this study is valuable, alone it is not sufficient for changes in the diabetes treatment guidelines to be implemented, as the study only represents a small proportion of those with diabetes.  For this study to lead the way, the clusters and associated complications will need to be verified in ethnicities and geographical locations to determine whether this new sub-stratification is scientifically relevant.

 

References

Ahlqvist, E. et al., 2018. Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. [Online]
Available at: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30051-2/fulltext?elsca1=tlpr
[Accessed 16 April 2018].

Collier, J., 2018. Diabetes: Study proposes five types, not two. [Online]
Available at: https://www.medicalnewstoday.com/articles/321097.php
[Accessed 16 April 2018].

Diabetes UK, 2014. Diabetes: Facts and Stats. [Online]
Available at: https://www.diabetes.org.uk/resources-s3/2017-11/diabetes-key-stats-guidelines-april2014.pdf
[Accessed 16 April 2018].

Gallagher, J., 2018. Diabetes is actually five seperate diseases, research suggests. [Online]
Available at: http://www.bbc.co.uk/news/health-43246261
[Accessed 16 April 2018].

NHS, 2018. Are there actually 5 types of diabetes?. [Online]
Available at: https://www.nhs.uk/news/diabetes/are-there-actually-5-types-diabetes/
[Accessed 16 April 2018].

The Week, 2018. What are the five types of diabetes?. [Online]
Available at: http://www.theweek.co.uk/health/92048/what-are-the-five-types-of-diabetes
[Accessed 16 April 2018].

World Health Organization, 2016. Global Report on Diabetes, Geneva: World Health Organization.

If you are a clinician, dietitian or laboratory who are interested in running diabetes assays, Randox offer a wide range of high-quality routine and niche assays including: fructosamine, glucose, HbA1c for diagnosing and monitoring diabetes, albumin, beta-2 microglobulin, creatinine, cystatin c, NEFA, microalbumin, and d-3-hydroxybutyrate to monitor associated complications, and adiponectin  as a biomarker for diabetes risk assessment.  These assays can be run on most automated biochemistry analysers.

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.

For more information, visit: https://dev.randox.com/diabetes-reagents or email: reagents@randox.com 


How Randox is helping to diagnose metabolic conditions

Metabolic health is a term used to describe a collection of required chemical reactions that take place in all living organisms. A metabolic disorder develops when an abnormal chemical reaction occurs which alters the normal metabolic process.

A common misconception surrounding metabolic health is that it refers solely to your weight, and if you are overweight you are considered to be unhealthy. But in actual fact this may not be entirely true. Good metabolism means that your body is in good overall health, which doesn’t account for just your weight! Common metabolic disorders include genetic metabolic disorders, diabetes and metabolic syndrome. Understanding and testing to see how well your metabolism is functioning is key to ensuring long lasting health.

Genetics

There are a number of genetic metabolic disorders caused by mutations of single genes. Examples of common disorders include Gaucher’s disease, hemochromatosis and cystic fibrosis. Gaucher’s disease is a genetic disorder that affects the body’s ability to break down fat that can accumulate in the liver/spleen and bone marrow. Hemochromatosis is a condition that is caused by the over-absorption and build-up of iron while cystic fibrosis is a metabolic disorder that appears as a result of a build-up of mucus in lungs/liver and intestines. Each of these metabolic disorders affect certain organs from functioning properly and therefore your overall healthiness.

Diabetes

Type 2 diabetes is one of the most common types of  metabolic disorders in the world that is expected to affect 592 million people by 2035. It is characterised by high blood sugar, insulin resistance or a lack of insulin being produced by the pancreas. Insulin resistance occurs when the body isn’t able to use insulin the right way which increases blood glucose levels. Insulin is needed for cells to take in glucose (sugar) from the bloodstream and convert it into energy. Over time this lack of insulin can damage the organs in your body.

Metabolic Syndrome

Metabolic syndrome (also known as syndrome X, Reaven’s syndrome, and CHAOS) is not a disease but a collection of risk factors that affect your health; these include high blood pressure, high blood sugar/cholesterol and abdominal fat. Left untreated, these risk factors, together, can lead to long term serious problems including an increased risk of heart disease, stroke and developing type 2 diabetes.

Can you improve your metabolic health?

Yes! The good news is that if you discover that your metabolic health is not up to scratch you can improve it through a combination of diet, exercise and lifestyle adjustments such as:

  • 30 minutes of moderate to intense exercise 5-7 times a week
  • Low-dose aspirin to reduce your risk of stroke or heart attack
  • Quit smoking
  • Medication for blood pressure/cholesterol/ blood sugar
  • Limit alcohol intake
  • Eat a healthy balanced diet

Related Products 

Randox has developed the RX series of clinical chemistry analysers for superior semi-automated and fully automated testing. The RX series extensive dedicated test menu goes beyond routine testing and has many unique and high-performance tests available. Our range of tests covers several parameters to assess your overall metabolic health.

Metabolic Health Profile

Albumin Chloride Potassium
Alkaline Phosphatase  C0Total Sodium
ALT Creatinine Total Bilirubin
AST (GOT) Glucose Total Protein
Direct Bilirubin Lactate Urea
Calcium

The RX series clinical chemistry analysers provide laboratories with a robust and smart solution ensuring you maintain a consistent workflow and can provide accurate results first time, every time. Offering excellent customer support services, our trained engineers are on hand to work with you in preserving the continuity of your operations while maximising the potential of your RX series instrument. Our world-famous test menu of high quality reagents ensures excellence in patient care, guaranteeing unrivalled precision and accuracy reducing costly test re-runs or misdiagnosis and offering complete confidence in results.

For more information visit: https://dev.randox.com/clinical-chemistry-analysers/

 

 

 


Looking after your kidney health during your pregnancy

With this year’s World Kidney Day theme focusing on women’s health and in particular, their kidney health, the campaign is drawing attention to the need for a higher awareness, timely diagnosis and proper follow-up of kidney issues amongst women.

One key area being highlighted by the campaign is the close links between pregnancy and kidney health problems.  The two are intrinsically connected – with CKD considered a high-risk factor for problematic pregnancies and reduced fertility, and in turn, pregnancy-related complications, including preeclampsia, can increase the risk of kidney disease.

Although not commonly known, women who have Chronic Kidney Disease are at increased risk of hypertensive disorders and premature births – which can be devastating for all involved.

Women with Chronic Kidney Disease who become pregnant also usually have mild kidney dysfunction, the severity of which will depend on the stage the CKD is at.

It is clear therefore that there is a need for increased awareness of Chronic Kidney Disease in pregnancy, to timely identify its existence before conception, and to monitor its progress before, during and after birth.

With a comprehensive panel of kidney health tests, Randox are working to ensure timely diagnosis of kidney function problems, to ensure that necessary treatment is administered at the earliest possible stage, when it is most likely to be successful.

Pregnant women, or women hoping to get pregnant in the future, can therefore determine their kidney health and be empowered to embark upon the necessary lifestyle changes or treatment required to ensure a safe and healthy pregnancy.

For example, the Randox test for albumin, low concentrations of which are the earliest marker of kidney damage, can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

In addition to albumin, there are a number of other highly specific and sensitive tests for kidney health, which are available as part of a Randox Health Check at our Randox Health Clinics. These include;

  • Estimated Glomerular Filtration Rate, which is an equation that considers age, gender, blood and protein levels to determine how well the kidneys are functioning.
  • Creatinine, which is a waste product produced by muscle tissue, and removed by the kidneys. When kidney function is diminished, creatinine levels increase.
  • Other proteins within the body which should be filtered by the kidneys, and are therefore measured to determine kidney function, include;

–              Cystatin C

–              Beta-2-Microglobulin

–              Microalbumin, which is not usually found in urine, but can appear when normal kidney function is impaired.

  • Minerals processed by the kidneys and analysed by Randox Health include;

–              Magnesium

–              Calcium

–              Phosphate

–              Potassium

–              Sodium

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With access to these high-performance kidney health tests, expectant mothers with kidney problems can be diagnosed early, before the condition develops into something more serious – keeping both you, and your baby healthy.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

 

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today. Speak to our team by phoning 0800 2545 130.

 

 

 


Randox Testing Services: Customer Testimonials from Ireland

At Randox Testing Services (RTS), we pride ourselves on helping our customers improve the health and safety of their working environment. Using our accurate and reliable testing methods and a range of additional services including training and policy reviews, we create tailored packages to meet the needs of our customers. We work with customers all over the world, but this month are highlighting the work we are doing across Ireland.

This month RTS will be attending the Northern Ireland Occupational Health, Hygiene and Wellbeing Conference at Titanic Belfast. This conference brings together companies from a range of industries all across Ireland to discuss the importance of employee health and wellbeing. As a company that began in Northern Ireland, RTS have always had strong connections with local businesses and are continually expanding our reach across Ireland.

Some of the companies with which we currently work, like GRAHAM construction, have recently provided feedback on our services. GRAHAM is based in Hillsborough, Co. Down and is a national construction, asset management and project investment business. They deliver services to a diverse range of clients from a network of regional offices, throughout the UK and Ireland.

GRAHAM Construction are proud to be partnered with Randox as their main Drug & Alcohol Service Provider. Over the years they have given a consistent, prompt, efficient, and professional service that delivered what was promised, when promised, to the proper agreed standards, which assists us in managing our relevant responsibilities with ease and confidence. I would have no hesitation in recommending them to others.”

This is great feedback to receive from such a reputable company who have a range of different testing needs. The construction industry is becoming more and more proactive when it comes to drug and alcohol testing. At RTS our experience working with GRAHAM and other major construction firms across the UK and Ireland means we are extremely well equipped to deal with the changing needs of this industry.

Another industry which requires a flexible and reliable drug and alcohol testing services provider is the aviation industry, especially when it comes to recruitment. We have been working with CAE Parc Aviation Services, the global leader in the provision of aviation personnel and support services to conduct pre-employment testing.

“We use Randox for Pre-Employment and Random Drug & Alcohol testing for select clients. We would happily recommend their services.”

Again, through working with various industries, the experience our staff possess is second to none. By qualifying the exact needs of our customers we create customised, cost-effective packages to ensure all testing needs are met.

As well as offering drug and alcohol testing services, our complete solution also includes a host of training, educational and consultancy services to equip our customers in tackling drug and alcohol misuse. Including comprehensive chain of custody training programs, which enables employers to conduct on-site collections to the same standard as a Randox Testing Services collection specialist.

The Henderson Group in Newtownabbey are another large company that has availed of the services offered by Randox Testing Services. The Henderson Group are the owners of the SPAR, EUROSPAR, ViVO, ViVOXTRA and ViVO Essentials franchises in Northern Ireland and have been distributing food and grocery-related products to the convenience retail sector for over 100 years.

“We switched provider for our Drug and Alcohol policy almost two years ago, moving to Randox.  The switchover was relatively seamless and the impact on our business has been positive.  Our tests are now all completed within target and we have realised a saving to boot.  We are glad we made the switch.”

 

 

Randox Testing Services is committed to tailoring our service to the needs of customers all over the world, and across the island of Ireland.

If your company would like to speak to us, please contact testingservices@randox.com

Alternatively you can contact David O’Regan, the Business Development Executive for Ireland directly: David.O’Regan@randox.com.

 

 


Take a proactive approach to your kidney health this World Kidney Day

On 8th March 2018, it’s World Kidney Day, a global campaign aimed at raising awareness of the importance of good kidney health. With a similar agenda to that of Randox, whose vision it is to ensure patients across the globe have access to the latest advancements in health technology, World Kidney Day works to reduce the frequency and impact of kidney disease and its associated health problems.

This year, the World Kidney Day theme is Kidneys and Women’s Health, to highlight that approximately 195 million women worldwide are affected by Chronic Kidney Disease. In 2018 World Kidney Day and International Women’s Day are recognised on the same date, offering the perfect opportunity to reflect on the importance of women’s health and specifically their kidney health.

CKD is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.

According to some studies, CKD is more likely to develop in women compared with men, with an average 14% prevalence in women compared to 12% in men.

However, the number of women successfully put on dialysis for their Chronic Kidney Disease is lower than the number of men – potentially due to slower progression of the disease, inequitable access to transplantation, and a general lower disease awareness.

It is therefore fitting that World Kidney Day has chosen Women’s Health as its theme for this year – due to the clear need for a higher awareness, timely diagnosis and proper follow up of kidney issues amongst women.

With a comprehensive panel of kidney health tests, Randox are working to ensure timely diagnosis of kidney function problems, to ensure that necessary treatment is administered at the earliest possible stage, when it is most likely to be successful.

For example, the Randox test for albumin, low concentrations of which are the earliest marker of kidney damage, can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

In addition to albumin, there are a number of other highly specific and sensitive tests for kidney health, which are available as part of a Randox Health Check at our Randox Health Clinics. These include;

  • Estimated Glomerular Filtration Rate, which is an equation that considers age, gender, blood and protein levels to determine how well the kidneys are functioning.
  • Creatinine, which is a waste product produced by muscle tissue, and removed by the kidneys. When kidney function is diminished, creatinine levels increase.
  • Other proteins within the body which should be filtered by the kidneys, and are therefore measured to determine kidney function, include;
  • Cystatin C
  • Beta-2-Microglobulin
  • Microalbumin, which is not usually found in urine, but can appear when normal kidney function is impaired.
  • Minerals processed by the kidneys and analysed by Randox Health include;
  • Magnesium
  • Calcium
  • Phosphate
  • Potassium
  • Sodium

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With access to these high-performance kidney health tests, patients with kidney problems can be diagnosed early, before the condition develops into something more serious.

Although end stage kidney failure affects only 0.05% of the general population, it commands between one and two billion pounds a year of the entire annual NHS budget. We know that loss of kidney function is devastating and hope our innovations can identify those at risk of kidney problems before they occur.

One such test for Chronic Kidney Disease risk measures levels of the protective hormone adiponectin, and is available exclusively at Randox.

Adiponectin can accurately assess levels of hidden and dangerous visceral fat within the body, which is the main cause of almost all the disorders associated with metabolic syndrome, including Chronic Kidney Disease. Assessing adiponectin can determine risk of CKD, as well as a range of other illnesses including prediabetes, cardiovascular disease and various cancers.

By using adiponectin to assess risk of kidney problems, we can empower individuals with the tools they need to prevent kidney problems in their future.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today. Speak to our team by phoning 0800 2545 130.

 


Liver Cirrhosis is a Global Health Burden

#LoveYourLiver this January.  This month, we are taking a closer look at Liver Cirrhosis.

 

Liver cirrhosis occurs when the healthy tissue of the liver is replaced with scar tissue (fibrosis) due to long-term liver damage.  Liver cirrhosis can result in liver failure which can be fatal.

 

Liver complications such as liver disease and cirrhosis can be detrimental if it is not treated or monitored.  Liver disease is the only major cause of death still increasing year-on-year.  Globally, deaths due to liver cirrhosis have increased from 676,000 in 1980 to over 1 million in 2010 (NCBI, 2014).   Cirrhosis and other chronic liver diseases have increased by 12.4% from 2006-2016 and was the cause of 1,256,900 deaths in 2016 (Global Burden of Disease, 2016).

There are a few factors that increase the risk of liver cirrhosis.  The three main factors are heavy alcohol consumption, an undiagnosed hepatitis infection, particularly hepatitis C, and non-alcoholic steatohepatitis (a more severe form of non-alcoholic fatty liver disease) due to obesity.

 

There are numerous symptoms associated with liver cirrhosis.  Some of the more severe symptoms include:

  • Jaundice – yellowing of the skin and whites of the eyes
  • Personality changes, confusion, difficulty concentrating, memory loss, or hallucinations
  • A tendency to bleed or bruise easily
  • In women, abnormal periods
  • In men, enlarged breasts, a swollen scrotum (the loose sac of skin that contains the testicles) or shrunken testicles
  • Vomiting
  • Diarrhea
  • Stomach pain – swollen or bloated stomach

Liver cirrhosis cannot be cured, but the aim of treatment is to manage the symptoms and complications, and to stop the condition getting worse.

#LoveYourLiver and prevent or reduce the symptoms of liver cirrhosis through: moderating alcohol consumption, not sharing needles to inject drugs, using a condom during sex, taking medications as prescribed, and maintaining a healthy weight.

 

The early stages of liver cirrhosis usually does not present any symptoms and is often first detected using routine blood tests.  Liver cirrhosis can be diagnosed and monitored through the following routine blood tests:

Alanine Aminotransferase (ALT)

ALT is one of the enzymes within the aminotransferases group and are among the most sensitive liver enzymes. The normal concentration levels of ALT in the blood are low, however, when the liver is damaged, such as liver cirrhosis, the levels of ALT increase.  During the diagnosis of liver cirrhosis, the root cause of the damage can be established, such as disease, drug or injury.  ALT is commonly measured alongside AST as part of the hepatic panel.

Aspartate Aminotransferase (AST)

AST is an enzyme found throughout the body. Elevated concentration levels of AST in the blood is directly correlated to the severity of the tissue damage.  AST also allows for the root cause of the damage to be diagnosed.  Excessive levels are indicative of damage due to acetaminophen overdose or acute viral hepatitis.  Moderately high levels are indicative of alcohol abuse.  Slightly high levels are indicative of cirrhosis.

AST is commonly measured alongside ALT as part of the hepatic panel, although ALT levels are higher in most types of liver damage.

Albumin

Albumin is a special protein made in the liver and provides the body with the proteins it requires to grow and repair tissue. The body requires a proper balance of albumin to prevent fluid from seeping out of blood vessels.  Decreased concentrations levels of this protein in the blood is an indicator of liver cirrhosis.

 

Randox supply a range of third party clinical diagnostic hepatic reagents to aid in the diagnosis and managing the complications of liver cirrhosis.  All reagents are available for use on a range of third party biochemistry analysers.  Randox offer the following hepatic reagents to diagnose liver cirrhosis:

Alanine Aminotransferase (ALT)

Aspartate Aminotransferase (AST)

Albumin

Randox also offer the following high performance and unique tests to diagnose liver cirrhosis:

5th Generation Bile Acids

Vanadate Oxidation Bilirubin

 

Why choose Randox reagents?

  • Randox offers the largest range of chemistries
  • Liquid ready-to-use reagents available
  • Automated applications for a wide range of clinical analysers
  • Excellent correlation to reference methods
  • Wide measuring ranges
  • Flexible pack sizes
  • Official accreditation to national and international standards including UKAS, ISO 13485:2003, and FDA.
  • Easy fit reagents
  • Easy read reagents

 

To request an application for your specific analyser, contact reagents@randox.com

 

For more information on liver function or to view our hepatic panel, visit https://dev.randox.com/liverfunction/


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