Diabetes mellitus is described as a chronic disease caused by genetic disposition and/or local environmental and lifestyle factors. It is estimated that every day in Australia approximately 275 adults develop diabetes and that a staggering 1 in 4 people over the age of 25 have diabetes or impaired glucose metabolism (pre-diabetes). That number is expected to continue rising, a fact largely attributed to declining dietary nutrition, lack of physical exercise and smoking.
When people develop diabetes either the body’s production of insulin stops (type 1), or it is no longer used effectively (type 2).* This results in abnormally high blood sugar levels which must be monitored and treated by periodically testing glucose levels complimented with adjustments in diet and exercise or the self-administration of insulin.
Virtually every system in the body is affected by diabetes mellitus an individual suffering from the disease does not comply with clinical recommendations it will inevitably lead to complications such as chronic kidney disease, retinopathy (eye disease), stroke, cardiovascular disease, amputations and ultimately, a premature death. Therefore, in order to maintain longevity and quality of life, it is extremely important to ensure that a patient manages the condition in an effective and responsible manner. In addition to this, reducing the prevalence of such complications relieves the strain on an overstretched health service and frees up valuable bed space and money for other needs, having an invaluable cumulative effect.
For this reason the level of glycosylated haemoglobin (HbA1c) present in a blood sample is measured every 3–6 months, which provides clinicians with an indication of the patients overall glycemic control. Based upon the results recommendations are made with the aim of maintaining or improving a patient’s management of the disease. This process typically involves a visit to the doctor, diabetes centre or pathology service to provide a blood sample, followed by a repeat visit to collect results and receive education from clinicians. It is a cumbersome and uneconomical process, especially in rural areas where return trips may require a large capital and time expenditure on behalf of the patient due to geographical location. In addition the healthcare provider experiences a similar strain on resources due to the administrative and time constraints placed upon them.
Luckily, there is an alternative and elegant solution to this problem.
Point of care analysers are small, automated, portable units which are used to undertake routine tests on the spot using a small volume of sample. They deliver results in extremely short time scales and offer numerous advantages over traditional methods of biological analysis. The A1cNow+ is a system that can measure HbA1c levels within just 5 minutes using 5 μL of blood drawn from a simple finger prick. Point of Care testing in this way has been championed by a number of health providers within Australia including Maari Ma Aboriginal Corporation, Baker IDI Heart and Diabetes Institute and Diabetes Australia (Queensland). They have all found that it greatly improves their standard of practice and its uptake is testament to the benefits utilising such technology can bring to the medical industry.
In addition to the considerable time and cost saving passed on to both the patient and healthcare provider by employing point of care technology, clinicians have the added assurance that results are up to date and relevant. Immediate feedback and pro-active patient education has been proven to increase compliance to clinical recommendations, resulting in statistically significant reductions in HbA1c levels., Furthermore, the experience of being tested is also less daunting and much more pleasant for the patient as the anxiety associated with veni-puncture is eliminated.
* Insulin is a natural hormone produced in the pancreas which regulates the binding of glucose (sugar) to haemoglobin.
- AusDiab Report 2005, http://www.diabetes.com.au/research.php?regionID=270&page=ausdiab_2004/05_report, Accessed 16th June 2009.
- AusDiab Report 2001, http://www.diabetes.com.au/pdf/AusDiab_Report.pdf, Accessed 16th June 2009.
- J. B. Brown, S. B. Harris, S. Webster-Bogaert and S. Porter, Diab. Spec., 17, 2004, 244-248.
- M. D. S. Shepherd, Clin. Biochem. Rev., 27, 2006, 161-170.