Home HbA1c test

[Amanda 4 willow]

I'd had the fortunate, or unfortuate situation of moving location 4 times since my son was diagnosed and I can easily say, every place has a different method of doing the HbA1c. Currently, they do my sons there at the clinic on an pretty much instant machine, which is great, but one clinic actually sent you home with capillary tubes after each clinic and you had to fill and send in the capillary tube 2 week before your next appointment to allow them to have an up to date result when you attended. Perhaps you could suggest this to your clinic because it means they dont' have to change their machines, to the new faster (and no doubt expensive ones) but it means you get to know what your HbA1c is when you need to know it and when you can discuss it with the doctor.

 

[markd]

While I take the points raised by mcmoby69 and phoenix about home A1c testing (and the paper about A1c variability makes very interesting reading) there is still an area where I think it has value. This for pre-diabtics who want to keep an eye on their progress (or lack of it) as time progresses.

Note that these comments do not relate to T1s.

I don't know about anyone else's GPs, but mine says there is no funding for any real sort of monitoring until you've developed diabetes fully.

This leaves most pre-diabetics in the position of diet/exercise and hope. There are a number of papers suggesting that earlier diagnosis/treatment can improve outcome, so early monitoring,I submit, is an advantage. In particular, I recently saw a paper that shows that Metformin remains an effective treatment for far longer (ie delays use of hypo-inducing agents like insulin or pancreatic stimulators) if patients start on it at an earlier stage of disease.

In some cases, the expectation is that it may delay such progression by a decade or more - this seems a pretty good trade-off to me!

Sure, there is an element of pandering to the 'worried well' with all sorts of informal home testing, but I think that occasional A1c measurements for prediabetics may well be a help in avoiding progression (or reducing the speed of said progression)

My regime now is to just check A1c every two months (varability in red cell life and other factors mean that A1c doesn't carry that much information after the first 8 - 10 weeks) and the occasional - maybe every couple of weeks - fasting and post-prandial reading.

I've been working in hospital-based healthcare for 35 years and it is clear that we need to more on prevention / risk reduction for diabetes (and other diseases). As a pre-diabetic, it is difficult to know if you are doing the 'right things' without some form of routine monitoring and a home A1c kit looks to be cheaper and less hassle than more frequent BG tests.

mark