Study of four POCT systems for HbA_1c measurement

Czech version

Authors: B. Friedecký ^1,2; J. Kratochvíla ²; J. Špirková ¹; M. Budina ²; V. Palička ¹
Authors‘ workplace: Ústav klinické biochemie a diagnostiky LF UK a FN Hradec Králové Přednosta: prof. MUDr. Vladimír Palička CSc. ¹; SEKK Pardubice Ředitel: Ing. Marek Budina ²
Published in: Prakt. Lék. 2011; 91(8): 485-488
Category: Of different specialties

Overview

Four POCT systems designed for HbA_1c measurement in blood were compared with a high quality laboratory method based on the HPLC principle and successfully controlled by a proficiency testing program provided by the European reference laboratory for HbA_1c (in The Netherlands).

The accuracy of all the systems tested was good and covers interval CV %=2.8–5.3.

Systematic errors, calculated as differences of individual POCT systems from laboratory HPLC method are high and range in intervals from -6.7 to -9.7%.

These systematic differences cause different classifications of diabetes compensation in patients (cut off 53 mmol/mol=5,3 % IFCC). The laboratory method classified 51 (74 %) of the patients analysed to be decompensated, while POCT systems only classified between 41(57 %) to 32 (44 %) patients as decompensated from the total number of 72 assessed patients.

Our conclusion is that where well-standardised laboratory methods are available, this is sufficient for patients’ needs and POCT measurement has no additive benefits. In fact with the possible differences in the therapeutic classification, it is more likely that use of POCT could increase the risk of insufficient treatment.

Key words:
HbA_1c, POCT, precision, compensation of diabetes.

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