Acomparison of point-of-care (POCT) HbA1c testing versus standard diabetes screening tests in family medicine clinic patients found that POCT HbA1c identified significantly more patients with previously undiagnosed hyperglycemia and prediabetes (Ann Fam Med 2017;15:162–4). The authors also determined that systematically screening patients via POCT HbA1c “greatly increases the chances for a screen to occur.”
The study compared POCT HbA1c and standard test results in demographically similar clinic patients who were at least 45 years old and not already diagnosed with diabetes who had not received HbA1c testing within the past year or taken steroids within the past 3 months. Overall, 324 were included in the standard practice arm of whom 73 (22%) received testing, nearly all undergoing fasting or random blood glucose tests. Another 164 patients underwent POCT HbA1c testing with 90% of those offered consenting to this type of testing.
POCT HbA1c in comparison to standard testing identified significantly more patients who unknowingly had diabetes or prediabetes, 10% and 53%, respectively, versus 8% and 33%. HbA1c cutoffs were ≤5.6% for euglycemia, >5.7–6.4% for prediabetes, and ≥6.5% for diabetes.
The authors concluded that because POCT HbA1c “effectively identifies individuals early in the course of the disease and allows for immediate assessment, patient education and early management, it is superior for identifying unknown chronic hyperglycemia, particularly prediabetes.” They did not provide analytical information about the POCT HbA1c methods used in the study.