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Point‐of‐care testing of HbA1c and blood glucose in a remote Aboriginal Australian community
Author(s) -
Martin David D,
Jones Timothy W,
Davis Elizabeth A,
Shephard Mark D S,
Freeman Hayley,
Maguire Graeme P,
Bulsara Max K
Publication year - 2005
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2005.tb00019.x
Subject(s) - medicine , diabetes mellitus , point of care , point of care testing , venous blood , plasma glucose , analyser , glucose meter , population , mean difference , limits of agreement , endocrinology , chromatography , nuclear medicine , chemistry , confidence interval , pathology , environmental health
Objectives: To assess the accuracy of point‐of‐care (POC) measurements of capillary blood glucose and glycosylated haemoglobin (HbA 1c ) levels in a remote Aboriginal community with high diabetes prevalence. Design: Cross‐sectional study comparing POC capillary glucose and HbA 1c results with those from corresponding venous samples measured in a reference laboratory. Participants and setting: 152 residents aged 11–76 years (representing 76% of population aged over 11 years) had POC glucose measurement in November 2003; 88 with POC glucose level ≥ 5.0 mmol/L, or self‐reported diabetes, had POC HbA 1c and laboratory glucose and HbA 1c measurements. Main outcome measures: POC fasting capillary levels of glucose (HemoCue Glucose 201 analyser, Medipac Scientific, Sydney) and HbA 1c (DCA 2000+ analyser, Bayer Australia, Melbourne); correlation and mean difference between capillary POC and venous blood laboratory measurements of glucose and HbA 1c . Results: Mean and median POC capillary glucose levels were 7.99 mmol/L and 6.25 mmol/L, respectively, while mean and median laboratory venous plasma glucose concentrations were 7.63 mmol/L and 5.35 mmol/L. Values for POC capillary HbA 1c and laboratory HbA 1c were identical: mean, 7.06%; and median, 6.0%. The correlation coefficient r for POC and laboratory results was 0.98 for glucose and 0.99 for HbA 1c . The mean difference in results was 0.36 mmol/L for glucose (95% CI, 0.13–0.62; limits of agreement [LOA], − 2.07 to 2.79 mmol/L; P = 0.007) and < 0.01% for HbA 1c (95% CI, − 0.07% to 0.07%; LOA, − 0.66% to 0.66%; P = 0.95), respectively. Conclusions: POC capillary HbA 1c testing, in particular, offers an accurate, practical, community‐friendly way of monitoring diabetes in rural and remote clinical settings. POC capillary glucose results should be confirmed by a laboratory test of venous plasma if the results are likely to significantly influence clinical decisions.