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...

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Autores principales: Mamtora S, Maghsoudlou P, Hasan H, Zhang W, El-Ashry M
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Publicado: Dove Medical Press 2021
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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
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