Comparison between point of care haemoglobin A1C and standard laborarory haemoglobin A1C at a tertiary leve diabetic clinic

Abstract

Point of care testing (POCT) refers to medical testing that is performed at or near a patient at a convenient time. Recently, POCT HbA1c devices have gained renewed interest in the management of diabetes, particularly in the public-health sector where resources are limited. The benefits of POCT HbA1c for diabetes care are varied, but they are particularly pronounced for patients who cannot afford the cost of transport to standard laboratories to have blood drawn for testing or for return visits to a hospital or clinic. The results of tests performed with POCT HBA1c devices are available far sooner than results obtained from a laboratory. This speedy availability of results could help to improve diabetes management and contribute to more effective patient care. For this study, which was conducted in a tertiary-level diabetic clinic, the precision, accuracy, ease of use and financial feasibility of using two widely available POCT devices were investigated, and the results compared with standard laboratory measurements. In addition, a survey to gauge participants’ awareness and basic knowledge of glycaemic control using A1C was conducted. The HbA1c of 100 type II diabetic patients was measured by means of the standard laboratory analyser (Dimension EXL with LM), and compared with measurements obtained by means of two POCT devices: (PTS Diagnostic A1C) A1C Now and Siemens DCA Vantage Analyzer. The laboratory results yielded a mean HbA1c of 8.59%; the AIC Now device had a mean of 9.17%, while the DC Vantage device produced a mean of 9.13. The results indicate that the performance of the POCT devices AIC Now and DCA Vantage are acceptable, and that they can be used to ensure rapid and convenient measures of HbA1c, which, in turn, may enhance patient care. In addition, the study revealed that in excess of 80% of the target population for this study were unaware of HbA1c as an indicator of long–term diabetic control which suggest that a concerted effort by health personnel is required to educate patients about HbA1c and the importance of glycaemic control