Our laboratory returns glycated hemoglobin A1c (HbA1c) measurement results within 72 hours. However, for diabetic patients who have a dubious follow-up (homeless, non-French-speaking people), HbA1c results are mandatory for the clinician during the consultation for immediate adjustments to treatment.
For this reason, we implemented a point of care testing (POCT) analyzer for HbA1c (DCA 2000, Bayer Diagnostics, Puteaux, France) in the endocrinology unit.
This project included formalization of a protocol agreement to define the sharing of the responsibilities and a procedure for the detection of hemoglobin variants in the laboratory that may induce interference with the POCT method.
The laboratory is responsible for overall quality management, training, procedures, quality controls, maintenance, failures management, and biological validation. The endocrinology unit performs blood sampling and testing, and uses results for treatments. During the 3-year study period, no increase in use was observed in the endocrinology unit with 11.1% of HbA1c measurements done using the POCT analyzer. One breakdown occurred leading to 21 days of outage. Nine patients with abnormal hemoglobin were detected.
This model of management is useful because of adjustments to treatment of patients with dubious follow-up and ensures a high level of quality for analysis performed outside the laboratory.
From the Department of Biochemistry A, Saint-Antoine Hospital, AP-HP, Paris, France.
Reprints: Pascal Pernet, MD, PhD, Service de Biochimie A, Hôpital Saint-Antoine, 184 rue du faubourg Saint-Antoine, 75571 Paris Cedex 11, France (e-mail: email@example.com).