Impact of Point-of-Care Testing of Glucose, Hemoglobin A1c, and Microalbumin-to-Creatinine Ratio in Managing/Diagnosing the Diabetic Patient

Abstract

Abstract

Historically, point-of-care testing has played a significant role in the diagnosis and management of wasting disease (diabetes mellitus). In addition to the plethora of blood glucose analyzers currently available, there are analyzers to quantify hemoglobin A1c (HbA1c) and microalbumin-to-creatinine ratios in a point-of-care testing setting. The evaluation of the analytical performance of these analyzers for these tests is usually performed in a laboratory setting by technologists familiar with instruments and may not be a good reflection of the analytical performance in the setting where the analyzer is used by nonlaboratory personnel. The imprecision obtained on a commonly used point-of-care testing analyzer (Bayer DCA 2000+) for HbA1c and microalbumin/creatinine analyzer by nonlaboratory, untrained, and skilled laboratory personnel was evaluated and found to be similar. Hemoglobin A1c and microalbumin/creatinine results obtained by the 3 groups compared well with that of a reference high-performance liquid chromatography method and nephelometric/colorimetric method. The impact of point-of-care testing in the management of diabetes in a remote setting in Australia is used as an example of the potential impact of this type of testing.