The Role of HBA1c Point-Of-Care Devices in Diagnosing and Managing Type II Diabetes Mellitus

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Background: Type II Diabetes Mellitus is a major disease burden. Unless controlled adequately it leads to multiple complications such as blindness and renal failure. Despite an array of treatments many patients still suffer with the complications of the disease. Currently disease status and severity are monitored using a biomarker of glycated haemoglobin (HBA1c). HBa1c is a robust biomarker of disease progression and therapy needs. However, it suffers several drawbacks, prime of which it is a laboratory-based test. This needs the patient to return to the clinic to get results and that also limits its use in rural populations where laboratory is not provided, and the transportation of samples is not easy. More recently point of care tests (PoC) tests have become available and there have been an increasing demand to relay on it solely on diagnosing DM. Aim: To find out if the current PoC HBA1c tests have sufficient accuracy to replace laboratory tests in the clinical setting and what are the advantages and disadvantages of PoC HBA1c testing. Methods: A literature review was conducted on the comparison of the performance characteristics of the current HBA1c tests to lab testing. Seven relevant articles were included in the analysis. Findings: The current HBA1c tests have a significant misclassification of T2DM, leading to patients being unnecessarily exposed to medication Conclusion: It cannot be recommended that the current PoC tests replace laboratory testing, but need to be seen as an adjunct to it