Home HbA1c test

[Snodger]

Forgive me if this topic's been covered before - I did a search but couldn't find exactly what I wanted answers to, and the science is moving pretty fast so things may have changed.

I was in my diabetes clinic the other day and was feeling annoyed that they never send you the results of HbA1c tests in time for you to do anything about it. They take the bloods then tell you the results the next time you come, which is months and months later and not much use.
I asked my doc if there was a chance of a home HbA1c test - like we now have home bg meters. She was very dismissive and said she couldn't see the point of a home test for HbA1c (!!!) and didn't know if they were developing one.

so my questions are:
1) does anyone know the latest? A google search shows me a bunch of send-your-blood-away tests, BUT also a google-scholar search shows me a reliable, well-tested device developed by Provalis (a UK company) which one site claims is the equivalent of 160 dollars for the home device and 7 dollars per test strip. But I can't get to a website for Provalis itself, presumably because they only sell to the medical profession? Can anyone else give an insight into any of this...?

2) What do you all think? Is there a point in home HbA1c tests? If the Provalis test were available, I'd actually save up and pay for that myself rather than take a half day off work to go to clinic for tests which I don't get the results for. Even if it's not a possibility right now to have a home test, if the medical device researchers bothered to ask me whether developing a good home test was worth while, I'd jump at the chance. If the NHS bothered to look into it, surely a reliable HbA1c device is worth developing - seven dollars every few months seems to me to be a good investment, especially when many trusts don't want type 2s to have daily bg test strips.
Thoughts?

 

[mcmoby69]

i ring my docs surgery after 7 days and they give them me over the phone. they should give them to you as they are your results and not top secret.

home hba1c tests, i wouldnt trust them and personally dont think i need them, a1c are only an average and as such a few good hypos can produce an awesome a1c after a good few highs! lol

 

[Sid Bonkers]

I agree with mcmoby, just ring your doc or clinic after a few days and they will tell you the results, dont forget to ask about kidney function (creatinine I believe) and cholesterol with a breakdown of hdl, ldl and trigs if bloods were taken for these.

With regular bg level testing and a 3 or 6 monthly HB A1c I dont see any reason for a home A1c test at all.

 

[badmedisin]

Some hospitals post a copy of the results because they realise that we need to know before our next 6 month (yeah, right, try 18 months...) appointment. We should all move to Sandwell.
Also they tend to send results to the gp, which may be more convenient. But I would try phoning the clinic and asking for the results. If they're unco-operative, remind them that the data protection act says they have to give you your info if you request it.

 

[Snodger]

Yes... (hollow laughter)... would be great if I could ring the clinic for an answer. Not even vaguely possible due to admin incompetence, phonelines staffed by robots, etc etc. I wouldn't trust them to tell me the correct info even if I could get through. (I did a test on the phoneline that is supposedly staffed 8am-6pm every day. Rang every hour to see how long it took to get through. The AVERAGE was over ten minutes of listening to muzak and a metallic voice saying: "you are.... number... seventeen... in the queue").
I've tried asking them to post it: they just don't. They apologise next time, but they still don't do it. And apparently they "aren't allowed" to use email to contact patients.

mcmoby, I'm currently a student so have been able to access a lot of the academic/medical literature on HbA1c tests and there ARE some "point of care" tests which have proved just as accurate as lab ones in peer-reviewed trials. The only problem is I can't find out how to get the devices. Personally I find it very useful to double-check my daily bgs with HbA1c - belt and braces approach- and I would prefer to do so more often than once in a blue clinic moon. But sounds as if that's just me!

I am moving my diabetes care to my GP soon so maybe that will be better, but the main thing is just the sheer hassle... it should be such a simple thing. I resent having to suck up to hospital admin and doctors to get vital info about my own body that I need to stay healthy.

 

[SophiaW]

I'm confused why it takes so long to get your results. When my daugher visits clinic we get the results back in under 10 minutes. They do the HbA1c test, then weigh and measure her, take blood pressure and check injection sites. By the time all that's finished the machine beeps and the test results are there to see.

 

[noblehead]

Snodger,

It is your right to have a copy of all your results sent to your home address, they cannot refuse this request. I request a copy of all letters sent between my gp and hospital consultants, so at your next appointment tell them that you wish this to be the case, failing that write a letter of complaint to your PCT.

Nigel

 

[candyfloss]

Oh Snodger you and I must be the only ones who would like a home HbA1c test! Everyone else on this forum is completely dismissive of them. Its fine if you have an enlightened Doctor (rare breed) who will graciously allow you an HbA1c test every three months but for those of us whose Doctors dont think we should test at all there isnt much choice is there?

But there is, sort of...

Do a search on Bayer A1CNow SelfCheck At-Home A1C System 2 Test Kit and you should come across Bayer's wonderful little meter for the purpose. The only catch is that it isnt available in the UK! Obviously to multi national Bayer we are just Insel Afen in a third world country and not deemed worthy to be sold their product (perhaps they think we are poor or all on benefits?). I emailed them not so long ago about selling it here and didnt get anywhere.
It is available in the US (of course!) where there is no NHS and more profit can be made and perhaps more people and their Doctors, who take their health seriously. There is an online U.S. store called Walgreens who sell it for $22.99 but, you guessed it, not available for international shipping. For some strange reason it can only be used twice then you chuck the meter in a landfill presumably but even at $11.50 per test its a lot better than forking out $160 + $7 per strip for Provalis even if it was available to us plebs here and can be used many times.

So what can we do? You can write to Bayer UK and complain like me and get nowhere or we can hop on a plane to the US for that holiday we promissed ourselves and bring back a suitcase of the things. Failing that do you have cousins in the U.S. that could ship them to you?

Finally, I believe there are A1c test kits through the internet where you can send off a sample of blood and the result is posted or emailed back to you. The price is a rip-off £17 + post I think.
Finally finally there are the quacks in places like Harley Street who will gladly test your everything. Remortgage your house before seeing them.

 

[pip]

Hi,
You can order a home Hba1c test here :
superliving.co.uk/pharmacy/your-health/diabetes/blood-glucose-test-strips/glucomen-a1c-blood-test-kit-1-test.html
(admin please remove if this is not allowed to be posted and accept my apologies)
I cannot vouch for it's accuracy, but I can say when I did the test - the results matched my meter average and was what I expected and the results were e-mailed to me the day after I posted it so good service.

 

[Snodger]

Pip and Candyfloss,

thank you! nice to feel I'm not going mad/expecting the unreasonable. I will investigate the options you suggest.
To everyone else who has responded, thank you too. Perhaps I didn't put myself across properly; my clinic WILL give me my HbA1c results, indeed they do give me them, but just not promptly. There's no point, to my mind, knowing what my results were several months ago when I'm trying to work out what I should be doing now. I don't really know what can be done about that; they are complying with the letter of the law but just not with the spirit. So I don't think a complaint will get me very far, because they haven't done anything WRONG, they just haven't done it USEFULLY.
SophiaW, it sounds as if your daughter's clinic has the point of care HbA1c test I was referring to earlier; you are lucky. Am I right that this is a paediatric clinic? From all I've heard, they are much better than adult clinics in terms of fitting care to the individual. Other type 1s at my clinic tell me something similar, that they used to get fairly instant results at the paed clinic, but the adult one sends bloods away to a lab somewhere.

 

[HLW]

Of course they are doing something wrong, you have said so yourself, they are not giving your results soon enough. Complain. The NHS won't improve on its own.

Personally I don't see the point of paying for something the NHS should provide, so I don't see the point of these home hba1c tests.

 

[SophiaW]

Snodger, yes it's a paediatric clinic, I didn't realise adults couldn't get their results straight away like our children do, that's ridiculous! I'd definitely complain to the NHS, and I think the whole diabetes community should come together and complain too. Ultimately our children are going to grow up and be at the receiving end of this inadequate care.

 

[markd]

Here's a post I made the other day on this topic, I'm quite pleased with the Bayer offering and I travel frequently enough that I'll always keep enough in stock now for a test every two months, instead of far more frequent conventional testing.

mark

*************************************************************
As I mentioned in answer to a question in the review section, I recently bought (while in Detroit), for the first time, a Bayer A1cNow test kit that gives results in 5 minutes.

It is very simple to use and around half the cost of the usual test kit that you mail to a lab.

When I used it for the first time last week, it gave me a value of 5.2, which is about what I was expecting. Using the same drop of blood, I also completed a test kit and mailed it to the lab the same day.

The email with the results came back today at 5.1 (reference normal range of 4.6 to 6.0) so, at first cut, the A1cNow looks to be reasonably accurate.

Those values equate to an average blood glucose of 4.7 to 4.8 which seems acceptable

As far as as I can see, the only places where major errors can creep in is in smearing too much blood around the 'shaker' or leaving the reagent pack open for too long before use.

I picked up another couple of packs - two tests each - and packed them for the trip home. As a pre-diabetic, I don't get the frequent A1c tests that diagnosed diabetics do, but at this price, I'll probably pretty much cut out ordinary testing and use these four to six times per year and save cash and fingertips.

Walmart (and probably the other discount phamramcists) don't ship internationally, but anyone over here can pick up test kits in Walamrt, Walgreens and CVS pharmacies - probably others too.

Might be useful for others in my position who want to keep a close eye on A1c status.

One nice thing is that it uses a tiny blood sample - same as a good blood glucose meter - rather than the huge blobs needed for the more common tests by post. Having an immediate answer is a real plus too.

mark.

 

[Snodger]

Markd - that's really useful, thank you. I must have missed that post when I was searching through the forum before.

In answer to the others - thank you for your support. I HAVE complained. As I said, they admit they are wrong and apologise when they don't send the results promptly. Then next time they do it again. After a while, you realise that getting angry about it is just not getting you anywhere.

Part of my original thought on this, though, was not so much about whether we should have to pay for our own HbA1c tests but whether it would be useful to be able to have home tests (on the NHS). Eg if they (researchers/manufacturers) developed them like they did for bg meters, you could do your own tests and take the results in for discussion with your consultant. No double appointments at GP then the clinic, no waiting for results. It's not always easy to take time off work/find childcare/ get to clinic appointments. And surely it would be better for type 2s who are struggling to get bg meters/strips on the NHS.

 

[lanzlady]

Hi Snodger,

I had my HbA1c taken today at 9.30am the delivery van was picking up other samples from doctors so she quickly labelled mine and went to reception with it I will have my results by Thursday morning I can phone down and get them or go to the surgery. This is up in the Highlands of Scotland in a small village. I think you should be able to do the same without having to wait that amount of time as you say you would like to know to rectify highs or lows before your next appointment I would have a chat with your GP or DN.

Good luck
Lanzady

 

[candyfloss]

Here's a post I made the other day on this topic, I'm quite pleased with the Bayer offering and I travel frequently enough that I'll always keep enough in stock now for a test every two months, instead of far more frequent conventional testing.

mark

*************************************************************
As I mentioned in answer to a question in the review section, I recently bought (while in Detroit), for the first time, a Bayer A1cNow test kit that gives results in 5 minutes.

It is very simple to use and around half the cost of the usual test kit that you mail to a lab.

When I used it for the first time last week, it gave me a value of 5.2, which is about what I was expecting. Using the same drop of blood, I also completed a test kit and mailed it to the lab the same day.

The email with the results came back today at 5.1 (reference normal range of 4.6 to 6.0) so, at first cut, the A1cNow looks to be reasonably accurate.

Those values equate to an average blood glucose of 4.7 to 4.8 which seems acceptable

As far as as I can see, the only places where major errors can creep in is in smearing too much blood around the 'shaker' or leaving the reagent pack open for too long before use.

I picked up another couple of packs - two tests each - and packed them for the trip home. As a pre-diabetic, I don't get the frequent A1c tests that diagnosed diabetics do, but at this price, I'll probably pretty much cut out ordinary testing and use these four to six times per year and save cash and fingertips.

Walmart (and probably the other discount phamramcists) don't ship internationally, but anyone over here can pick up test kits in Walamrt, Walgreens and CVS pharmacies - probably others too.

Might be useful for others in my position who want to keep a close eye on A1c status.

One nice thing is that it uses a tiny blood sample - same as a good blood glucose meter - rather than the huge blobs needed for the more common tests by post. Having an immediate answer is a real plus too.

mark.

Mark thanks for your posting on this product - interesting to read how fairly easy it is to use and its accuracy. Backs up what I read elsewhere.
Would be nice if any representatives from Bayer UK reading this forum could comment on why it's not for sale in the UK.

Snodger, I sort of get the impression about this whole home testing thing, especially as it relates to type 2's on diet, is that the NHS has an attitude of 'a little knowledge is a dangerous thing'. In other words doctors would rather we didnt know what our daily BG or A1c was otherwise we may start dictating to them what our treatment should be or questioning their judgment. Lets face it, diabetes research is so fast moving & widely available for any to read on the internet, I cant imagine many GP's or the NHS can keep up with it and given that I read many stories, just on this forum, about how poor their treatment of diabetes is.
There again, maybe I'm just being paranoid.

 

[markd]

Looks like someone ships them to the UK:

uk.ebid.net/for-sale/bayer-a1c-now-at-home-selfcheck-2-test-kit-nib-26410465.htm

Rather expensive compared to buying them there, but still not a bad deal compared to two of the Glucomen by posts tests purchased in the UK.

mark

 

[jopar]

I have my bloods a week before going to clinic, so the consultant has my latest available to him..

As for home HbA1c testing, I peronsally can't see the point, if you already doing your bg testing and this is fine, you HbA1c is also likely to be fine..

As to why Abbott don't sale there HbA1c meter here... It's all to do with licencing of the product before it can be sold here or in Europe...

Licencing a medical device for use is complex and very expensive, The advantage with licencing in America is that you get a much larger catchment of people to sell the product too as you deal.. In Europe you first need to gain the licence first then individual countries afterwards..

So it's more cost effective to release in America first, see how your product is recieved and whether any unknown problems araise with mass use.. Then you go through the rigimole of sorting out the European side of things..

It all to do with cost of licencing in each area nothing to do with what health care system any country got..

 

[phoenix]

I think that the market for home tests in the UK would be very small. The answers on here show that most people are able to get tests and their results from NHS sources.
I have to say I like the system here,(not UK). I get a prescription from the doc for the tests , I go when I want to the lab copy . A of the results arrives in the post 2 days later. It only takes 2 days because my lab has to send the blood to another one for HbA1cs, other test results normally come next morning.
At the beginning when all the various tests were new to me. It was really useful to be able to find out about them before I visited the doctor, then I could ask relevant questions.(though I'm not sure my doc feels the same as I've sent her looking up things in textbooks more than once :lol: )
It also means I've got all my results to compare, or if I move show to a new doctor.

 

[mcmoby69]

mcmoby, I'm currently a student so have been able to access a lot of the academic/medical literature on HbA1c tests and there ARE some "point of care" tests which have proved just as accurate as lab ones in peer-reviewed trials. The only problem is I can't find out how to get the devices. Personally I find it very useful to double-check my daily bgs with HbA1c - belt and braces approach- and I would prefer to do so more often than once in a blue clinic moon. But sounds as if that's just me!

i have posted a link that shows why i am not an avid follower of A1c's as i said they are just a guide to overall control.

http://care.diabetesjournals.org/conten ... /2756.full

i am not fan of most diabetic sites as some of the advice leaves a lot to be desired. i prefer to surround myself with people who have actually 'lived' diabetes than use results from lab tests on animals . i also think that a lot of research is interpreted incorrectly and is biased in favour of whoever is funding the research. i have registered with several medical websites which gives me access to medical papers and research, this helps me work out what works best for me.
my technical background as a gas registered plumber provides me with the knowledge to sort the wheat from the chaff!