Glucose and Glycated Haemoglobin Point-of-care Testing and Early Diagnosis of Diabetes and Pre-diabetes

The number of individuals with impaired glucose metabolism (‘pre-diabetes’) and type 2 diabetes is reaching epidemic proportions. This increase is associated with higher cardiovascular morbidity and mortality. Early screening for diabetes and pre-diabetes (i.e. elevated glucose and/or glycated haemoglobin [HbA 1c ]) may aid in the reduction of diabetes-related complications. Point-of-care testing, defined as testing at or near the site of the patient, is able to bring diagnostic tests and its associated therapeutic actions immediately to the patient and may aid in the detection of diabetes and the reduction of complications. However, the majority of available point-of-care testing devices for glucose and HbA 1c do not meet generally accepted analytical performance criteria and may underestimate the true risk of diabetes. Until these analytical performance issues have been addressed properly, caution should be exercised in the use of point-of-care testing of glucose and HbA1c in the diagnosis of and screening for pre-diabetes and diabetes.