Lara A Motta1, Mark D S Shephard2, Julie Brink3, Stefan Lawson4, Paul Rheeder5. 1. Flinders University International Centre for Point-of-Care Testing, Sturt Campus, West Wing, Level 3, Flinders University, Bedford Park, South Australia 5042, Australia. Electronic address: Lara.Motta@flinders.edu.au. 2. Flinders University International Centre for Point-of-Care Testing, Sturt Campus, West Wing, Level 3, Flinders University, Bedford Park, South Australia 5042, Australia. Electronic address: Mark.Shephard@flinders.edu.au. 3. Project HOPE South Africa, Wild Fig Business Park, Block F, Unit 54, 1494 Cranberry Street, Honeydew, Johannesburg 2170, South Africa. Electronic address: jbrink@projecthope.org. 4. Project HOPE, 255 Carter Hall Lane, Millwood, VA 22646, USA. Electronic address: slawson@projecthope.org. 5. Dept. Internal Medicine, Steve Biko Academic Hospital, University of Pretoria, Bophelo Road, Pretoria, South Africa. Electronic address: Paul.Rheeder@up.ac.za.
Abstract
INTRODUCTION: Diabetes is a major health problem in South Africa. DiabCare Africa found just 47% of diabetes patients had a hemoglobin A1c (HbA1c) test for their management in the previous year. METHODS: Patients attending an urban diabetes clinic near Johannesburg, run by Project HOPE, accessed HbA1c (and urine albumin:creatinine ratio) point-of-care testing (POCT) as part of a quality-assured international program called ACE (Analytical and Clinical Excellence). Patients who had two or more HbA1c POC tests from 2012 to 2014 were assessed to determine their change in glycaemic control. RESULTS: The mean (±SD) HbA1c in this group of diabetes patients (n=131) fell significantly from 9.7%±2.4 (83mmol/mol) at their first POCT measurement to 8.4%±2.4 (68mmol/mmol/mol) at their most recent POCT measurement (paired t-test p<0.01). The average time between first and most recent HbA1c test was 15 months. The number of diabetes patients achieving optimal glycaemic control (HbA1c≤6.5-7.5% [48-58mmol/mol) increased by 125%, while the number with very poor glycaemic control (HbA1c>10% [86mmol/mol]) halved. An association was observed between degree of glycaemic control and increasing albuminuria in this cohort. DISCUSSION: POCT has promoted change in clinical practice by facilitating greater accessibility to HbA1c testing.
INTRODUCTION:Diabetes is a major health problem in South Africa. DiabCare Africa found just 47% of diabetespatients had a hemoglobin A1c (HbA1c) test for their management in the previous year. METHODS:Patients attending an urban diabetes clinic near Johannesburg, run by Project HOPE, accessed HbA1c (and urine albumin:creatinine ratio) point-of-care testing (POCT) as part of a quality-assured international program called ACE (Analytical and Clinical Excellence). Patients who had two or more HbA1c POC tests from 2012 to 2014 were assessed to determine their change in glycaemic control. RESULTS: The mean (±SD) HbA1c in this group of diabetespatients (n=131) fell significantly from 9.7%±2.4 (83mmol/mol) at their first POCT measurement to 8.4%±2.4 (68mmol/mmol/mol) at their most recent POCT measurement (paired t-test p<0.01). The average time between first and most recent HbA1c test was 15 months. The number of diabetespatients achieving optimal glycaemic control (HbA1c≤6.5-7.5% [48-58mmol/mol) increased by 125%, while the number with very poor glycaemic control (HbA1c>10% [86mmol/mol]) halved. An association was observed between degree of glycaemic control and increasing albuminuria in this cohort. DISCUSSION: POCT has promoted change in clinical practice by facilitating greater accessibility to HbA1c testing.
Authors: Sean Duffy; Derek Norton; Mark Kelly; Alejandro Chavez; Rafael Tun; Mariana Niño de Guzmán Ramírez; Guanhua Chen; Paul Wise; Jim Svenson Journal: Glob Health Sci Pract Date: 2020-12-23
Authors: Jorge César Correia; Sarah Lachat; Grégoire Lagger; François Chappuis; Alain Golay; David Beran Journal: BMC Public Health Date: 2019-11-21 Impact factor: 3.295