Publication
Home monitoring of haemoglobin A1c in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability
Publisher:
Wiley
Date:
17-01-2023
DOI:
10.1111/DME.15033
Abstract: In the UK people with diabetes who do not attend annual review appointments often have higher haemoglobin A 1c (HbA 1c ) levels. We aim to determine the acceptability of self‐collected posted capillary blood s les, and if they produce accurate and reliable HbA 1c results. We include adult studies comparing capillary blood to venous blood for measuring HbA 1c . We exclude methods not suitable for postage. Electronic databases of MEDLINE, Embase, CINAHL, Web of Science, Google Scholar and OpenGrey were searched from inception to September 2021, as well as relevant conference abstracts. Two reviewers performed study selection, data extraction and risk of bias assessment independently. Narrative synthesis was performed. Our search retrieved 3747 records. Following de‐duplication and screening 30 articles were included. The mean difference (MD) and limits of agreement (LoA) between capillary and venous HbA 1c were smaller and narrower respectively when micro/capillary tubes (micro/cap) were used for capillary blood storage compared to dried blood spots (capDBS) (micro/cap MD range −0.4 to 1.4 mmol/mol vs. capDBS MD range −4.3 to 7.2 mmol/mol, micro/cap LoA width 2.4 to 6 mmol/mol vs. capDBS LoA width 11.7 to 16.8 mmol/mol). After using self‐collection kits, 83%–96% of participants reported satisfaction, 87%–99% found it easy and 69%–94% reported they would use it again. Microtubes/capillary tubes look promising as a method of self‐collecting and posting capillary blood s les for the measurement of HbA 1c based on the accuracy and reliability findings presented. DBS s les demonstrated comparatively poorer accuracy. Data on acceptability were limited and further research is needed.