[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IP] Lab A1C vs. In-office (Poll)

Shelly Tyler <email @ redacted> wrote:

> What difference have you found between the Lab A1C results and the
> (6 minute or so) machine?  I have heard someone say the lab is lower and
> office higher...and vice versa?

Shelly, here's what I wrote a while back when this came up.

--- Begin Quote ___

< Professional Mode = ON >

We're now very close to what I do for a living.

Unless the physician's office is very well staffed, the office equipment is
almost certainly one that falls in the waived category of laboratory tests
under the Clinical Laboratory Improvement Amendments of 1988 (CLIA 88), and,
as such, has the same accuracy and precision requirements of our personal
blood glucose meters - that is the results must be within 5% of a standard
(i.e. the "gold standard" lab test -- column hemochromatography) 50% of the
time.  Informally, that works out to +/- 20%.  Further, the directions must be
written so as to be understood and followed by someone with a seventh grade
education and no further training.  IOW, the office HbA1c tests are probably
OK for screening, but for good reliability, the lab test is required.  As you
point out, the office test runs about $30 per test whereas the lab test can be
as much as $150 per test.

< Professional Mode = OFF >

Additional material:  while the waived version is probably sufficient to get a
general picture of your control most of the time, I think I'd ask for a lab
test to be done once a year, and that would be the standard against which to
measure the test done in the doctor's office.

Jim Handsfield
mailto:email @ redacted

The opinions expressed are mine and do not necessarily reflect those of my
wife who runs this house and makes more important decisions than I do.
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml