HbA1c point-of-care testing

Abstract

The HbA1c fraction of glycated hemoglobin is widelyused in monitoring of the diabetes treatment andas a retrospective indicator of glycemia should bemeasured in each patient every three months.Number of HbA1c measurements performed in Polandis significantly below the clinically justified needs andinsufficient availability of such tests is consideredone of the reasons. For HbA1c measurements twogroups of analytical methods are used — chromatographyand immunoassays. Many of these methodsare certified in the National GlycohemoglobinStandardization Program (NGSP), in which the ionexchangehigh-pressure liquid chromatography isused as the reference method. Each analyticalmethod certified in the NGSP can be regarded asequivalent to the reference method. HbA1c point-of--care testing (POCT) allows for the greatest possiblereduction of turn-around time. Some commerciallyavailable methods, reagents and analyzers used forPOCT have NGSP certificate, although some of themdo not meet standards of precision and accuracy conditioning their full diagnostic use. In numerousclinical trials the usefulness of HbA1c POCT in everydaypractice and beneficial impact on the quality ofdiabetes care have been demonstrated, although theonly meta-analysis published so far indicates thatcurrently there is insufficient scientific evidence ofthe effectiveness of such testing, and further researchis needed. Nevertheless, available data indicate thatHbA1c POCT can be a significant improvement ofdiabetes care. (Diabet. Klin. 2012; 1, 1: 38–42)