Does performing a Point-Of-Care HbA1c test increase the chances of undertaking an OGTT among individuals at risk of diabetes? A randomized controlled trial

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM Primary Care Diabetes Pub Date : 2024-09-23 DOI:10.1016/j.pcd.2024.09.005

Ramón A. Castaño , Maria A. Granados , Natalia Trujillo , Juan P. Bernal , Juan F. Trujillo , Patrizia Trasmondi , Angel F. Maestre , Juan S. Cardona , Rossmary Gonzalez , María A. Larrarte , Derly C. Hernandez , Noël C. Barengo , Humberto Reynales

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Abstract

Aims

Early detection of type 2 diabetes mellitus is key to reducing micro and macrovascular complications associated with this disease. However, a lab-based process for diagnosis entails the risk of loss-to-follow-up. The objective of this study was to demonstrate if performing a point-of-care test of HbA1c immediately after a screening questionnaire will increase the proportion of individuals showing up for a lab-based confirmatory test as Point-of-care (POC) provides immediate availability, which is expected to reduce loss-to-follow-up.

Research design and methods

This trial was a two-arm, randomized controlled, open-label study. Participants were recruited using the FINDRISC Score in a primary care and community setting. All 902 eligible participants were randomized into the intervention (n=511) and control (n=391) group. The intervention group was given information on healthy lifestyles, and a Point-of-care POC-HbA1c test was performed during the same visit. The control group was only given information on healthy lifestyles. Participants in both groups received a written prescription to have an oral glucose tolerance test (OGTT) performed within the next 30 days. Follow-up phone calls were made at 30 and 90 days to check if participant had undergone the test. The total duration of the intervention was 8 months. The posterior data analysis was made by using the Kolmogorov-Smirnoff test for the quantitative variables, and the descriptive statistics were expressed as means and standard deviation, or median and interquartile range 25 %-75 %, as appropriate.

Results

At 30 days, 28 % of participants in the intervention group and 26.1 % in the control group undertook the OGTT (RD 1.90 %; 95 % CI −3.94; 7.73). At 90 days, 35.8 % of participants in the intervention group and 37.1 % in the control group undertook the OGTT. There was no statistically significant difference (RD – 3.17 %; 95 % CI −7.04; 0.70) between both groups.

Conclusions

The data suggest that performing a POC-HbA1c test after the FINDRISC did not increase the percentage of individuals showing up for the OGTT.

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进行护理点 HbA1c 检测是否会增加糖尿病高危人群进行 OGTT 的机会？随机对照试验。

目的：早期发现 2 型糖尿病是减少与该疾病相关的微血管和大血管并发症的关键。然而，以实验室为基础的诊断过程存在随访损失的风险。本研究的目的是证明在筛查问卷后立即进行 HbA1c 护理点检测是否会提高接受实验室确诊检测的人数比例，因为护理点 (POC) 可提供即时可用性，有望减少随访损失：该试验是一项双臂、随机对照、开放标签的研究。在初级保健和社区环境中使用 FINDRISC 评分招募参与者。所有符合条件的 902 名参与者被随机分为干预组（511 人）和对照组（391 人）。干预组获得了有关健康生活方式的信息，并在同一次就诊中进行了护理点 POC-HbA1c 检测。对照组只获得健康生活方式的信息。两组参与者都收到了一份书面处方，要求在未来 30 天内进行口服葡萄糖耐量试验 (OGTT)。30 天和 90 天后，我们会通过电话跟进，检查参与者是否接受了测试。干预总持续时间为 8 个月。对定量变量采用Kolmogorov-Smirnoff检验进行后效数据分析，描述性统计以均值和标准差或中位数和四分位数间距25%-75%表示：30 天时，干预组和对照组分别有 28% 和 26.1% 的参与者进行了 OGTT 测试（RD 1.90 %; 95 % CI -3.94; 7.73）。90 天后，干预组和对照组分别有 35.8% 和 37.1% 的参与者进行了 OGTT 测试。两组之间没有明显的统计学差异（RD - 3.17 %; 95 % CI -7.04; 0.70）：数据表明，在 FINDRISC 后进行 POC-HbA1c 检测并不会提高参加 OGTT 的人数比例。

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来源期刊

Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE

CiteScore

5.00

自引率

3.40%

发文量

134

审稿时长

47 days

期刊介绍： The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.

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