Patient-determined glycosylated hemoglobin measurements: an aid to patient education

The feasibility of patient determination of fast fraction hemoglobin (HbA1) was evaluated. In the laboratory, the fast fraction method correlated well with known mixed standards of between 0 and 40% hemoglobin A1c (r2 = 0.97, slope 1.19) and reasonably well with radioimmunoassay (r2 = 0.78, slope 1.09), although prepackaged columns performed poorly about 18% of the time. Sixteen patients practicing home blood monitoring performed the determination of HbA1 on their own blood obtained from fingerstick. Two hours of patient training were required for the procedure. The correlation of patient determination of HbA1 with the results obtained by the laboratory on venous blood was reasonable (r2 = 0.81 with a slope of 0.88). Patient performance of HbA1 was useful in (1) providing enhanced reinforcement for self-monitoring programs, (2) engaging patients in groups in the monitoring process, and (3) providing an educational tool with which to teach pathophysiologic principles involved in diabetes mellitus.