scholarly journals Systematic Diabetes Screening Using Point-of-Care HbA1c Testing Facilitates Identification of Prediabetes

2017 ◽  
Vol 15 (2) ◽  
pp. 162-164 ◽  
Author(s):  
Heather P. Whitley ◽  
Courtney Hanson ◽  
Jason M. Parton
Keyword(s):  
Point Of Care ◽  
Diabetes Screening

Point-of-Care HbA1c—A Case for Diabetes Screening and Diagnosis

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1518-P
Author(s):  
CARRIE J. SZABLOWSKI ◽  
EMILY SUSCHA ◽  
KADDY DAVIS ◽  
CHARLES Z. XIE ◽  
KEITH MOSKOWITZ ◽  
...  
Keyword(s):  
Point Of Care ◽  
Diabetes Screening ◽  
Screening And Diagnosis

scholarly journals Performance of Point-of-Care Testing Compared with the Standard Laboratory Diagnostic Test in the Measurement of HbA1c in Indonesian Diabetic and Nondiabetic Subjects

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Afiat Berbudi ◽  
Nofri Rahmadika ◽  
Adi Imam Tjahjadi ◽  
Rovina Ruslami
Keyword(s):  
Health Care ◽  
Community Health ◽  
Blood Sample ◽  
Point Of Care ◽  
Community Health Care ◽  
Standard Laboratory ◽  
Diabetes Screening ◽  
Point Of Care Testing ◽  
Diagnostic Laboratory ◽  
Hba1c Measurement

Objective. This study is aimed at investigating if point-of-care testing for HbA1c (POCT-HbA1c) using the HemoCue® HbA1c 501 system could be an alternative method for diabetes screening and monitoring to replace the HbA1c measurement in a standard diagnostic laboratory. Design. This was a cross-sectional study to assess the agreement between POCT and a standard laboratory measurement method for determining the level of HbA1c. Setting and Participants. In total, 108 participants were recruited to participate in this study, consisting of 61 diabetics and 47 nondiabetics. The diabetic group comprised 37 females and 24 males, diagnosed with type 2 diabetes mellitus (DM) and undergoing diabetes treatment at several community health care centres in Bandung, West Java. The nondiabetic group consisted of 15 female and 32 male patients of several community health care centres and healthy volunteers. Sample Collection and Analysis. A venous blood sample was taken for routine HbA1c analysis by the diagnostic laboratory method. For the POCT-HbA1c, a blood sample was taken from the fingertip at the same time and analysed with the HemoCue® HbA1c 501 system. Outcome Measures. The HbA1c results of both methods were compared and analysed with a Bland-Altman agreement plot. The sensitivity and specificity of the POCT-HbA1c data were also compared with those of the standard diagnostic results. Results. Based on the Bland-Altman plot, the HbA1c level for 100 out of 108 (92.59%) subjects analysed by the POCT-HbA1c was within the range of the 95% limit of agreement. Compared with the standard diagnostic assay, the sensitivity of the POCT-HbA1c was 97.83% and its specificity was 77.42%. Conclusions. The high sensitivity and accuracy of POCT-HbA1c indicate that it is a potential method for diabetes screening and monitoring to replace the routine diagnostic laboratory HbA1c measurement, especially when a rapid result is required.

scholarly journals Pharmacy Diabetes Screening Trial: protocol for a pragmatic cluster-randomised controlled trial to compare three screening methods for undiagnosed type 2 diabetes in Australian community pharmacy

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017725 ◽  
Author(s):  
Ines Krass ◽  
Rob Carter ◽  
Bernadette Mitchell ◽  
Mohammadreza Mohebbi ◽  
Sophy T F Shih ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Outcome Measure ◽  
Point Of Care ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Diabetes Screening ◽  
Cluster Randomised ◽  
Randomised Controlled ◽  
Screening Trial

IntroductionWith the rising prevalence of type 2 diabetes in Australia, screening and earlier diagnosis is needed to provide opportunities to intervene with evidence-based lifestyle and treatment options to reduce the individual, social and economic impact of the disease. The objectives of the Pharmacy Diabetes Screening Trial are to compare the clinical effectiveness and cost-effectiveness of three screening models for type 2 diabetes in a previously undiagnosed population.Methods and analysisThe Pharmacy Diabetes Screening Trial is a pragmatic cluster randomised controlled trial to be conducted in 363 community pharmacies across metropolitan, regional and remote areas of Australia, randomly allocated by geographical clusters to one of three groups, each with 121 pharmacies and 10 304 screening participants. The three groups are: group A: risk assessment using a validated tool (AUSDRISK); group B: AUSDRISK assessment followed by point-of-care glycated haemoglobin testing; and group C: AUSDRISK assessment followed by point-of-care blood glucose testing. The primary clinical outcome measure is the proportion of newly diagnosed cases of type 2 diabetes. Primary outcome comparisons will be conducted using the Cochran-Mantel-Haenszel test to account for clustering. The secondary clinical outcomes measures are the proportion of those who (1) are referred to the general practitioner (GP), (2) take up referral to the GP, (3) are diagnosed with pre-diabetes, that is, impaired glucose tolerance or impaired fasting glucose and (4) are newly diagnosed with either diabetes or pre-diabetes. The economic outcome measure is the average cost (direct and indirect) per confirmed new case of diagnosed type 2 diabetes based on the incremental net trial-based costs of service delivery and the associated incremental longer term health benefits from a health funder perspective.Ethics and disseminationThe protocol has been approved by the Human Research Ethics Committees at University of Sydney and Deakin University. Results will be available on the Sixth Community Pharmacy Agreement website and will be published in peer reviewed journals.Trial registration numberACTRN12616001240437; Pre-results.

scholarly journals Clinic-based diabetes screening at the time of HIV testing and associations with poor clinical outcomes in South Africa: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachel W. Kubiak ◽  
Mario Kratz ◽  
Ayesha A. Motala ◽  
Sean Galagan ◽  
Sabina Govere ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Point Of Care ◽  
Clinical Care ◽  
Risk Groups ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Diabetes Diagnosis ◽  
Diabetes Screening ◽  
Number Needed To Screen

Abstract Background HIV clinical care programs in high burden settings are uniquely positioned to facilitate diabetes diagnosis, which is a major challenge. However, in sub-Saharan Africa, data on the burden of diabetes among people living with HIV (PLHIV) and its impact on HIV outcomes is sparse. Methods We enrolled adults presenting for HIV testing at an outpatient clinic in Durban. Those who tested positive for HIV-infection were screened for diabetes using a point-of-care hemoglobin A1c (HbA1c) test. We used log-binomial, Poisson, and Cox proportional hazard models adjusting for confounders to estimate the relationship of diabetes (HbA1c ≥ 6.5%) with the outcomes of HIV viral suppression (< 50 copies/mL) 4–8 months after antiretroviral therapy initiation, retention in care, hospitalization, tuberculosis, and death over 12 months. Results Among 1369 PLHIV, 0.5% (n = 7) reported a prior diabetes diagnosis, 20.6% (95% CI 18.5–22.8%, n = 282) screened positive for pre-diabetes (HbA1c 5.7–6.4%) and 3.5% (95% CI 2.7–4.6%, n = 48) for diabetes. The number needed to screen to identify one new PLHIV with diabetes was 46.5 persons overall and 36.5 restricting to those with BMI ≥ 25 kg/m2. Compared to PLHIV without diabetes, the risk of study outcomes among those with diabetes was not statistically significant, although the adjusted hazard of death was 1.79 (95% CI 0.41–7.87). Conclusions Diabetes and pre-diabetes were common among adults testing positive for HIV and associated with death. Clinic-based diabetes screening could be targeted to higher risk groups and may improve HIV treatment outcomes.

Abstract # P-1: Use of Type 2 Diabetes Screening Guidelines in Primary Care: Concordance Between Physician Survey and Medical Records

2016 ◽  
Vol 22 ◽  
pp. 14
Author(s):  
Michelle Mocarski ◽  
Sandhya Mehta ◽  
Karin Gillespie ◽  
Tami Wisniewski ◽  
K.M. Venkat Narayan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Medical Records ◽  
Physician Survey ◽  
Diabetes Screening ◽  
Screening Guidelines

“Aspirin - resistance”? A few critical considerations on definition, terminology, diagnosis, clinical value, natural course of atherosclerotic disease, and therapeutic consequences

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 429-438 ◽  
Author(s):  
Berent ◽  
Sinzinger
Keyword(s):  
Platelet Function ◽  
Point Of Care ◽  
Aspirin Resistance ◽  
Point Of View ◽  
Evidence Based ◽  
Platelet Function Tests ◽  
Clinical Value ◽  
Vascular Events ◽  
Therapeutic Consequences ◽  
Function Tests

Based upon various platelet function tests and the fact that patients experience vascular events despite taking acetylsalicylic acid (ASA or aspirin), it has been suggested that patients may become resistant to the action of this pharmacological compound. However, the term “aspirin resistance” was created almost two decades ago but is still not defined. Platelet function tests are not standardized, providing conflicting information and cut-off values are arbitrarily set. Intertest comparison reveals low agreement. Even point of care tests have been introduced before appropriate validation. Inflammation may activate platelets, co-medication(s) may interfere significantly with aspirin action on platelets. Platelet function and Cox-inhibition are only some of the effects of aspirin on haemostatic regulation. One single test is not reliable to identify an altered response. Therefore, it may be more appropriate to speak about “treatment failure” to aspirin therapy than using the term “aspirin resistance”. There is no evidence based justification from either the laboratory or the clinical point of view for platelet function testing in patients taking aspirin as well as from an economic standpoint. Until evidence based data from controlled studies will be available the term “aspirin resistance” should not be further used. A more robust monitoring of factors resulting in cardiovascular events such as inflammation is recommended.

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