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Point-of-Care HbA1c Testing with the A1cNow Test Kit in General Practice Dental Clinics: A Pilot Study Involving Its
Shiela M Strauss1, Mary Rosedale1, Michael A Pesce2
1College of Nursing, New York University, New York, New York, USA.
Point of Care
|January 17, 2015
Summary
Dental clinics can screen for diabetes using the A1cNow device, but practical challenges and false positives limit its effectiveness. Laboratory testing may be a more reliable screening strategy.
Area of Science:
- Diabetes screening
- Point-of-care testing
- Dental public health
Background:
- Millions remain undiagnosed with pre-diabetes and diabetes, necessitating alternative screening locations.
- Dental settings offer a potential venue for identifying individuals with out-of-range glucose levels.
Purpose of the Study:
- To evaluate the feasibility and accuracy of the A1cNow point-of-care device for diabetes screening in dental clinics.
- To compare the A1cNow device's performance against laboratory-based High Performance Liquid Chromatography (HPLC) testing.
Main Methods:
- The A1cNow device was used for point-of-care glucose screening in a university dental college.
- Evaluations included practical usability by healthcare professionals and accuracy (sensitivity, specificity) compared to HPLC.
- American Diabetes Association thresholds were used for pre-diabetes and diabetes classification.
Main Results:
- Evaluable readings were obtained for only 70% of subjects, with usability challenges noted in the busy clinic environment.
- Sensitivities for pre-diabetes and diabetes were high (91.9% and 100%, respectively).
- Specificities were lower (66.7% for pre-diabetes, 82.4% for diabetes), indicating a significant number of false positives.
Conclusions:
- The A1cNow device presents practical limitations and a high false-positive rate for diabetes screening in dental settings.
- A patient- and provider-friendly, laboratory-based analysis may be a more effective screening strategy, reducing the burden on dental teams.
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