From Seldovia, Alaska, USA:
I understand that there are now home collection kits available for HbA1C blood glucose test. Where can we obtain these kits and what is the literature on them?
This question was referred to several members of the Diabetes Team, who have each given an answer:
Answer from Dr. O'Brien:There is some information you need to have before tackling the business of home kits for blood samples.
The first is the method your diabetes doctor uses for A1c's. Very roughly this will fall into one of two categories. Either he/she will have an instrument like the Ames 2000 in the office which can make the measurement in a few minutes and has the great advantage that it requires very little blood and can make the result available to the doctor at the time of the office visit. Normally there would be no need to send samples in by mail; but I can see that in Alaska, especially in winter, you might want to keep track of control, but simply not be able to get to the doctor's office at all readily.
The second possibility is that the doctor takes a small venous sample and forwards it to a hospital or a commercial laboratory. The turn-around time is of necessity rather longer and the doctor may want to have the sample sent in a few days before your visit in order to have the result by the time you come in. In either case the laboratory or the doctor's office should be responsible for supplies. In the case of a large hospital or commercial laboratory the usual practise would be to ask for a venous blood sample taken into a capped glass or plastic tube about 40mm x 8mm in size and containing an anticoagulant. You would need to get a local visiting nurse to draw the sample for you. If the doctor or indeed the laboratory was using an instrument that used only microliter amounts of blood like the Ames 2000 it would be much easier. You could then prick your finger, exactly as for a blood sugar, and draw a sample up into a small capillary tube, about 10 cm long and 1 mm internal diameter. These tubes also contain an anticoagulant. The sample is capped either with a little plastic stopper or with a dab of modelling clay and mailed in the fold of a piece of corrugated paper. Sometimes small plastic tubes can serve the same purpose. Again, at least to begin with, you need to get the appropriate mailing container from the unit that is going to do the test. Drops of blood on a filter paper, the kind of sampling used in neonatal screening, has not been very successful.
Answer from Dr. Robertson:We don't use home "kits" but I have some experience of using this system for research. There are at least two methods:
- Filter paper collection of a drop of blood at your home, then mail it, with elution and analysis in the lab.
- Collection of a tiny drop of blood into a BioRad capillary tube which is then dropped into a small Eppendorf container which contains a stabilising and haemolysing fluid. The whole lot is shaken vigorously and sent in the post. This methodology has been shown to be ideal for postal HbA1c and is stable for several weeks at room temperature.
[Editor's note: I have recently tried to contact the company in the US that makes the home HbA1c test product, but to no avail. As soon as I do, I will post information about the product within the Products section. JSH]
Original posting 6 May 97
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Last Updated: Tuesday April 06, 2010 15:08:54
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