Two studies published in Diabetes Care (citations below) have shown that when patients can discuss their HbA1c reading with their diabetes team during a clinic visit, their blood glucose control improved significantly. This makes sense intuitively. Given how busy families are, and how overbooked most clinics are, if you don’t discuss your HbA1c at the time of the clinic visit, you’re unlikely to discuss it all and therefore you won’t have a chance to make adjustments in care.

In a poll we ran in July 2014, the overwhelming majority of our readers report finger stick HbA1c testing in the clinic. 62% report finger stick HbA1c testing in the clinic, compared with 49% in March 2003. Yet 32% report still getting a venous blood draw, compared with 37% in March 2003. Both show a trend toward greater use of HbA1c tests that can be performed immediately in the clinic and which allow patients to discuss the results immediately with their diabetes team.

If your diabetes team does not use a device that measures HbA1c immediately, you have a couple options:

  1. Arrange to have the blood drawn a week or so before your regular clinic visit so that the results are available to discuss with your diabetes team.
  2. Purchase a home HbA1c test kit and perform the measurement yourself. Discuss the results with your diabetes team during your clinic visit.
  3. Find another diabetes team.

References:

  1. Effect of Point-of-Care on Maintenance of Glycemic Control as Measured by A1C [Diabetes Care 30:713-715, 2007]
  2. HbA1c Measurement, which includes descriptions of the home HbA1c kits on the market today.
  3. Immediate feedback of HbA1c levels improves glycemic control in type 1 and insulin-treated type 2 diabetic patients [Diabetes Care 22:1785-1789, 1999]. Full text available as PDF.
  4. Rapid A1c Availability Improves Clinical Decision-Making in an Urban Primary Care Clinic [Diabetes Care 26:1158-1163, 2003]. Full text available as HTML and PDF.