Point-of-care testing of HbA1c and blood glucose in a remote Aboriginal Australian community.

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  • Additional Information
    • Source:
      Publisher: Australasian Medical Publishing Co Country of Publication: Australia NLM ID: 0400714 Publication Model: Print Cited Medium: Print ISSN: 0025-729X (Print) Linking ISSN: 0025729X NLM ISO Abbreviation: Med J Aust Subsets: MEDLINE
    • Publication Information:
      Publication: : Pyrmont, NSW : Australasian Medical Publishing Co.
      Original Publication: Sydney : Australasian Medical Pub. Co.
    • Subject Terms:
      Blood Glucose* ; Glycated Hemoglobin* ; Native Hawaiian or Other Pacific Islander*; Community Health Services/*statistics & numerical data ; Diabetes Mellitus, Type 2/*diagnosis ; Point-of-Care Systems/*organization & administration ; Rural Health Services/*statistics & numerical data; Adolescent ; Adult ; Aged ; Australia/epidemiology ; Child ; Clinical Laboratory Techniques ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results
    • Abstract:
      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 > or = 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.
    • Comments:
      Erratum in: Med J Aust. 2005 Jun 20;182(12):656. Bulsara, Max K [added].
      Comment in: Med J Aust. 2005 May 16;182(10):498-9. (PMID: 15896175)
    • Accession Number:
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
    • Publication Date:
      Date Created: 20050518 Date Completed: 20050825 Latest Revision: 20221207
    • Publication Date:
      20240628
    • Accession Number:
      10.5694/j.1326-5377.2005.tb00019.x
    • Accession Number:
      15896181