1
|
Gomez-Peralta F, Abreu C, Andreu-Urioste L, Antolí AC, Rico-Fontsaré C, Martín-Fernández D, Resina-Rufes R, Pérez-García JJ, Negrete-Muñoz Á, Muñoz-Álvarez D, Umpierrez GE. Point-of-care capillary HbA1c measurement in the emergency department: a useful tool to detect unrecognized and uncontrolled diabetes. Int J Emerg Med 2016; 9:7. [PMID: 26894895 PMCID: PMC4760960 DOI: 10.1186/s12245-016-0107-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/11/2016] [Indexed: 11/13/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Fernando Gomez-Peralta
- Endocrinology and Nutrition Unit, Hospital General de Segovia, c/ Miguel Servet S.N., 40003, Segovia, Spain.
| | - Cristina Abreu
- Endocrinology and Nutrition Unit, Hospital General de Segovia, c/ Miguel Servet S.N., 40003, Segovia, Spain.
| | - Leonor Andreu-Urioste
- Department of Internal Medicine, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Ana Cristina Antolí
- Department of Internal Medicine, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Carmen Rico-Fontsaré
- Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - David Martín-Fernández
- Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Rosa Resina-Rufes
- Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Juan Jesús Pérez-García
- Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Ángela Negrete-Muñoz
- Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Daniel Muñoz-Álvarez
- Emergency Department, Hospital Nuestra Señora de Sonsoles, C/ Avda. Juan Carlos I, s/n, 05004, Ávila, Spain.
| | - Guillermo E Umpierrez
- General Clinical Research Center, Emory University, 49 Jesse Hill Jr. Dr., Atlanta, GA, 30303, USA.
| |
Collapse
|