Systematic Diabetes Screening Using Point-of-Care HbA_1c Testing Facilitates Identification of Prediabetes

The Article in Brief

Systematic Diabetes Screening Using Point-of-Care A1C Testing Facilitates Identification of Prediabetes

Heather P. Whitley , and colleagues

Background With millions of Americans unknowingly living with chronic high blood sugar, there is a need to more quickly and easily identify and treat patients with unknown hyperglycemia. Standard screening, which typically uses fasting blood glucose measured through a chemistry panel, can be inconvenient, highly variable and can delay care. By contrast, HbA1c testing is durable and more accurately reflects sustained hyperglycemia. This study compares these two approaches for identifying patients with chronic hyperglycemia.

What This Study Found Systematically offered HbA1c point-of-care testing is superior to standard practice, according to study findings. Specifically, standard practice screened only 22 percent of patients, most commonly by blood glucose. Comparing glycemic outcomes, in the standard practice arm, six patients were found to have diabetes and 24 patients were found to have prediabetes. By contrast, point-of-care HbA1c screening identified 104 patients with diabetes and 88 patients with prediabetes.

Implications

• The authors conclude that because point-of-care HbA1c testing 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.