Point-of-care capillary HbA1c measurement in the emergency department: a useful tool to detect unrecognized and uncontrolled diabetes

被引：16

作者：

Gomez-Peralta F. ^{[1
]}

Abreu C. ^{[1
]}

Andreu-Urioste L. ^{[2
]}

Antolí A.C. ^{[2
]}

Rico-Fontsaré C. ^{[3
]}

Martín-Fernández D. ^{[3
]}

Resina-Rufes R. ^{[3
]}

Pérez-García J.J. ^{[3
]}

Negrete-Muñoz Á. ^{[3
]}

Muñoz-Álvarez D. ^{[3
]}

Umpierrez G.E. ^{[4
]}

机构：

[1] Endocrinology and Nutrition Unit, Hospital General de Segovia, c/ Miguel Servet S.N., Segovia

[2] Department of Internal Medicine, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, Ávila

[3] Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, Ávila

[4] General Clinical Research Center, Emory University, 49 Jesse Hill Jr. Dr., Atlanta, 30303, GA

来源：

International Journal of Emergency Medicine | 2016年 / 9卷 / 1期

关键词：

Diabetes; Emergency medicine; Point-of-care HbA1c; Public health; Screening;

D O I：

10.1186/s12245-016-0107-6

中图分类号：

学科分类号：

摘要：

Background: Inpatient hyperglycaemia and diabetes mellitus (DM) are common and are associated with an increased risk of complications and mortality. The severity of hyperglycaemia determines the rate of complications in patients treated in the emergency department (ED). Our aim was to examine whether determination of the capillary haemoglobin A1c (HbA1c) is a reliable method for detecting unknown diabetes and poor glycaemic control in the ED. Methods: A prospective observational study was conducted in adult (>18 years) patients treated in a single-centre ED. We compared the results of HbA1c levels measured by Bio-Rad in2it point-of-care device on a capillary blood sample and by the hospital laboratory. Results: A total of 187 ED patients with an average age of 57.1 ± 19.2 years were studied. The mean HbA1c value was 5.78 ± 1.26 % by capillary POC testing and 6.10 ± 1.12 % by the hospital laboratory (correlation = 0.712, P < 0.001). A total of 17.1 % of cases had a prior diagnosis of DM. The diagnosis of DM (plasma glucose > 126 mg/dL and/or HbA1c > 6.5 %) was made in ten (5.4 %) additional cases (prior undiagnosed DM) for a total prior DM prevalence of 22.5 % (95 % CI 16.4–28.5 %). Capillary HbA1c detected 11 additional cases of unknown DM (5.9 %). A capillary HbA1c value greater than 6 % has a sensitivity of 85.7 % and specificity of 85.3 % for the screening of DM. Conclusions: Determination of the capillary HbA1c in the ED is a reliable, fast, and simple system for the screening of unknown or uncontrolled DM. © 2016, Gomez-Peralta et al.

引用

页码：1 / 6

页数：5

共 24 条

[1]

Zelihic E., Poneleit B., Siegmund T., Haller B., Sayk F., Dodt C., Hyperglycemia in emergency patients—prevalence and consequences: results of the GLUCEMERGE analysis, Eur J Emerg Med, 22, pp. 181-187, (2015)

[2]

Pulsinelli W.A., Levy D.E., Sigsbee B., Scherer P., Plum F., Increased damage after ischemic stroke in patients with hyperglycemia with or without established diabetes mellitus, Am J Med, 74, pp. 540-544, (1983)

[3]

Weir C.J., Murray G.D., Dyker A.G., Lees K.R., Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long term follow up study, BMJ, 7090, pp. 1303-1306, (1997)

[4]

Umpierrez G.E., Isaacs S.D., Bazargan N., You X., Thaler L.M., Kitabchi A.E., Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes, The Journal of Clinical Endocrinology and Metabolism, 87, pp. 978-982, (2002)

[5]

Vinagre I., Mata-Cases M., Hermosilla E., Morros R., Fina F., Rosell M., Et al., Control of glycemia and cardiovascular risk factors in patients with type 2 diabetes in primary care in Catalonia (Spain), Diabetes Care, 35, pp. 774-779, (2012)

[6]

American Diabetes Association, (2) Classification and diagnosis of diabetes, Diabetes Care, 38, pp. S8-S16, (2015)

[7]

Silverman R.A., Thakker U., Ellman T., Wong I., Smith K., Ito K., Et al., Hemoglobin A1c as a screen for previously undiagnosed prediabetes and diabetes in an acute-care setting, Diabetes Care, 34, pp. 1908-1912, (2011)

[8]

Petersen J.R., Omoruyi F.O., Mohammad A.A., Shea T.J., Okorodudu A.O., Ju H., Hemoglobin A1c: assessment of three POC analyzers relative to a central laboratory method, Clin Chim Acta, 411, pp. 2062-2066, (2010)

[9]

Marley J.V., Oh M.S., Hadgraft N., Singleton S., Isaacs K., Atkinson D., Cross-sectional comparison of point-of-care with laboratory HbA<sub>1</sub>c in detecting diabetes in real-world remote aboriginal settings, BMJ Open, 5, (2015)

[10]

Rowan C.P., Miadovnik L.A., Riddell M.C., Rotondi M.A., Gledhill N., Jamnik V.K., Identifying persons at risk for developing type 2 diabetes in a concentrated population of high risk ethnicities in Canada using a risk assessment questionnaire and point-of-care capillary blood HbA1c measurement, BMC Public Health, 14, (2014)

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