Accuracy, Patient Acceptance and Clinical Application of Capillary HbA1cMonitoring

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Abstract
HbA1c values in capillary blood (50 microliters) were compared with venous samples, assayed by HPLC (normal less than 6.6%) in 64 Type 1 and Type 2 diabetic patients. One group (n = 43) collected capillary blood in the Outpatient Department simultaneously with a venous sample. The capillary sample collection was not supervised. A second group (n = 21) obtained two capillary samples during routine home blood glucose monitoring in Unistep containers within 2 days of the venous sample and posted them to the laboratory with a questionnaire about the ease of use and acceptance of the method. In the home collection group, 97% returned samples, there were no postal losses, and 75% returned questionnaires. Although 18% of patients had difficulty collecting the samples, all preferred the Unistep method to venepuncture. Correlation of capillary and venous samples was good for patients (r = 0.97, n = 53). The mean absolute difference between the two methods was 0.36 +/- 0.04 (+/- SE) %Hb. Eleven samples had to be excluded (insufficient blood; samples undated). The standard deviation for capillary duplicates was 0.14%, at a mean of 8.7%. During laboratory storage capillary HbA1c was initially slightly higher than corresponding venous values with some decrease (7.7% to 7.2%) over 7 days. HbA1c values in home-collected samples are accurate and reproducible when compared with venous samples assayed by HPLC, and the method was acceptable to patients.

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