Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting
Sunil Mamtora, 1 Panayiotis Maghsoudlou, 1, 2 Hani Hasan, 1 Wenrui Zhang, 3 Mohamed El-Ashry 1 1Department of Ophthalmology, Great Western Hospital, Swindon SN3 6BB, UK; 2Department of Developmental Biology, University College London, London WC1E 6BT, UK; 3Department of Ophthalmology, Queen Eliza...
Guardado en:
Autores principales: | , , , , |
---|---|
Formato: | article |
Lenguaje: | EN |
Publicado: |
Dove Medical Press
2021
|
Materias: | |
Acceso en línea: | https://doaj.org/article/00e9d4b78e93487ca47ef9176fbe7e36 |
Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
id |
oai:doaj.org-article:00e9d4b78e93487ca47ef9176fbe7e36 |
---|---|
record_format |
dspace |
spelling |
oai:doaj.org-article:00e9d4b78e93487ca47ef9176fbe7e362021-12-02T11:55:47ZAssessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting1177-5483https://doaj.org/article/00e9d4b78e93487ca47ef9176fbe7e362021-01-01T00:00:00Zhttps://www.dovepress.com/assessing-the-clinical-utility-of-point-of-care-hba1c-in-the-ophthalmo-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Sunil Mamtora, 1 Panayiotis Maghsoudlou, 1, 2 Hani Hasan, 1 Wenrui Zhang, 3 Mohamed El-Ashry 1 1Department of Ophthalmology, Great Western Hospital, Swindon SN3 6BB, UK; 2Department of Developmental Biology, University College London, London WC1E 6BT, UK; 3Department of Ophthalmology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UKCorrespondence: Panayiotis MaghsoudlouUniversity College London, London, UKTel +44 020 7242 9789Fax +44 020 7905 2000Email p.maghsoudlou@ucl.ac.ukBackground/Aims: Effective management of diabetic retinopathy requires multidisciplinary input. We aimed to evaluate the impact of point of care (POC) HbA1c testing as a tool to identify patients most in need of specialist diabetologist input and assess the accuracy and determinants of patients’ insight into their glycaemic and blood pressure control.Methods: Forty-nine patients with diabetic retinopathy were recruited from the eye clinic at Great Western Hospital. Patients completed a questionnaire and POC HbA1c and blood pressure values were measured. Statistical analysis was completed with SPSS v23.Results: Mean age was 64.4 years, median interval since the last formal HbA1c reading was 10.2 months and the mean POC HbA1c was 64.1 mmol/mol. HbA1c significantly correlated with the degree of retinopathy. Of the patients, 81.6% had POC readings above the levels recommended by the National Institute for Health and Care Excellence, with only 16.3% having insight into this. Insight to HbA1c levels was predicted by age but not by duration of disease. Fourteen patients (33.3%) identified with high HbA1c readings were referred to secondary diabetic services and 88.8% of patients felt that the test was useful and likely to improve their diabetic control.Conclusion: The majority of patients had poor insight into their diabetes control, with sub-optimal treatment and follow-up. Poor insight is high in younger patients, suggesting that POC HbA1c testing is particularly important in educating younger patients who may be Type 1 diabetics with more severe disease. POC HbA1c represents a cost-effective, reproducible and clinically significant tool for the management of diabetes in an outpatient ophthalmology setting, allowing the rapid recognition of high-risk patients and appropriate referral to secondary diabetic services.Keywords: diabetic retinopathy, glycemic control, point of care testing, HbA1cMamtora SMaghsoudlou PHasan HZhang WEl-Ashry MDove Medical Pressarticlediabetic retinopathyglycaemic controlpoint of care testinghba1c.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 41-47 (2021) |
institution |
DOAJ |
collection |
DOAJ |
language |
EN |
topic |
diabetic retinopathy glycaemic control point of care testing hba1c. Ophthalmology RE1-994 |
spellingShingle |
diabetic retinopathy glycaemic control point of care testing hba1c. Ophthalmology RE1-994 Mamtora S Maghsoudlou P Hasan H Zhang W El-Ashry M Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting |
description |
Sunil Mamtora, 1 Panayiotis Maghsoudlou, 1, 2 Hani Hasan, 1 Wenrui Zhang, 3 Mohamed El-Ashry 1 1Department of Ophthalmology, Great Western Hospital, Swindon SN3 6BB, UK; 2Department of Developmental Biology, University College London, London WC1E 6BT, UK; 3Department of Ophthalmology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UKCorrespondence: Panayiotis MaghsoudlouUniversity College London, London, UKTel +44 020 7242 9789Fax +44 020 7905 2000Email p.maghsoudlou@ucl.ac.ukBackground/Aims: Effective management of diabetic retinopathy requires multidisciplinary input. We aimed to evaluate the impact of point of care (POC) HbA1c testing as a tool to identify patients most in need of specialist diabetologist input and assess the accuracy and determinants of patients’ insight into their glycaemic and blood pressure control.Methods: Forty-nine patients with diabetic retinopathy were recruited from the eye clinic at Great Western Hospital. Patients completed a questionnaire and POC HbA1c and blood pressure values were measured. Statistical analysis was completed with SPSS v23.Results: Mean age was 64.4 years, median interval since the last formal HbA1c reading was 10.2 months and the mean POC HbA1c was 64.1 mmol/mol. HbA1c significantly correlated with the degree of retinopathy. Of the patients, 81.6% had POC readings above the levels recommended by the National Institute for Health and Care Excellence, with only 16.3% having insight into this. Insight to HbA1c levels was predicted by age but not by duration of disease. Fourteen patients (33.3%) identified with high HbA1c readings were referred to secondary diabetic services and 88.8% of patients felt that the test was useful and likely to improve their diabetic control.Conclusion: The majority of patients had poor insight into their diabetes control, with sub-optimal treatment and follow-up. Poor insight is high in younger patients, suggesting that POC HbA1c testing is particularly important in educating younger patients who may be Type 1 diabetics with more severe disease. POC HbA1c represents a cost-effective, reproducible and clinically significant tool for the management of diabetes in an outpatient ophthalmology setting, allowing the rapid recognition of high-risk patients and appropriate referral to secondary diabetic services.Keywords: diabetic retinopathy, glycemic control, point of care testing, HbA1c |
format |
article |
author |
Mamtora S Maghsoudlou P Hasan H Zhang W El-Ashry M |
author_facet |
Mamtora S Maghsoudlou P Hasan H Zhang W El-Ashry M |
author_sort |
Mamtora S |
title |
Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting |
title_short |
Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting |
title_full |
Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting |
title_fullStr |
Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting |
title_full_unstemmed |
Assessing the Clinical Utility of Point of Care HbA1c in the Ophthalmology Outpatient Setting |
title_sort |
assessing the clinical utility of point of care hba1c in the ophthalmology outpatient setting |
publisher |
Dove Medical Press |
publishDate |
2021 |
url |
https://doaj.org/article/00e9d4b78e93487ca47ef9176fbe7e36 |
work_keys_str_mv |
AT mamtoras assessingtheclinicalutilityofpointofcarehba1cintheophthalmologyoutpatientsetting AT maghsoudloup assessingtheclinicalutilityofpointofcarehba1cintheophthalmologyoutpatientsetting AT hasanh assessingtheclinicalutilityofpointofcarehba1cintheophthalmologyoutpatientsetting AT zhangw assessingtheclinicalutilityofpointofcarehba1cintheophthalmologyoutpatientsetting AT elashrym assessingtheclinicalutilityofpointofcarehba1cintheophthalmologyoutpatientsetting |
_version_ |
1718394787526082560 |