Does performing a Point-Of-Care HbA1c test increase the chances of undertaking an OGTT among individuals at risk of diabetes? A randomized controlled trial

Aims: Early detection of type 2 diabetes mellitus is key to reducing micro and macrovascular complications associated with this disease. However, a lab-based process for diagnosis entails the risk of loss-to-follow-up. The objective of this study was to demonstrate if performing a point-of-care test of HbA1c immediately after a screening questionnaire will increase the proportion of individuals showing up for a lab-based confirmatory test as Point-of-care (POC) provides immediate availability, which is expected to reduce loss-to-follow-up.

Research design and methods: This trial was a two-arm, randomized controlled, open-label study. Participants were recruited using the FINDRISC Score in a primary care and community setting. All 902 eligible participants were randomized into the intervention (n=511) and control (n=391) group. The intervention group was given information on healthy lifestyles, and a Point-of-care POC-HbA1c test was performed during the same visit. The control group was only given information on healthy lifestyles. Participants in both groups received a written prescription to have an oral glucose tolerance test (OGTT) performed within the next 30 days. Follow-up phone calls were made at 30 and 90 days to check if participant had undergone the test. The total duration of the intervention was 8 months. The posterior data analysis was made by using the Kolmogorov-Smirnoff test for the quantitative variables, and the descriptive statistics were expressed as means and standard deviation, or median and interquartile range 25 %-75 %, as appropriate.

Results: At 30 days, 28 % of participants in the intervention group and 26.1 % in the control group undertook the OGTT (RD 1.90 %; 95 % CI -3.94; 7.73). At 90 days, 35.8 % of participants in the intervention group and 37.1 % in the control group undertook the OGTT. There was no statistically significant difference (RD - 3.17 %; 95 % CI -7.04; 0.70) between both groups.

Conclusions: The data suggest that performing a POC-HbA1c test after the FINDRISC did not increase the percentage of individuals showing up for the OGTT.