ESPE Abstracts (2015) 84 P-2-254

Can We Rely on Finger Stick Haemoglobin A1c? Comparison of Levels Assayed by DCA 2000 with IFCC Reference Method in a Paediatric Cohort

Gianluca Tornesea,b, Nadia Milica, Laura Spettia, Daniela Gembrinia, Carmen Loganesa, Maria Chiara Pellegrinb, Lucia Radilloa, Oriano Radilloa, Elena Faleschinia & Alessandro Venturaa,b

aInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy; bUniversity of Trieste, Trieste, Italy

Background: DCA 2000 is still a very popular device to determine HbA1c levels in diabetes practices through a finger stick. It allows clinicians to give immediate feedback to patients and to make changes in diabetes management during the three-monthly assessment.

Objective and hypotheses: To compare HbA1c values measured with DCA 2000 with corresponding values measured with IFCC (considered as the reference method) in a single paediatric centre, to assess the reliability of DCA values.

Method: 100 Caucasian paediatric patients (47 female; median age 13.2 years, IQR 9.5–15.9) with type 1 diabetes mellitus were enrolled during their annual review. HbA1c was measured for each patient using both the DCA 2000 and the laboratory IFCC assay.

Results: The laboratory HbA1c values ranged 26–102 mmol/mol had a median of 62.4 mmol/mol (IQR 52.0 – 72.1). The DCA 2000 HbA1c values had a median of 8.1% (IQR 7.3 – 8.9) which corresponded to 64.5 mmol/mol (IQR 56.0 – 73.8). Values between the two methods were strongly correlated (Spearman, r=0.951, P < 0.001) with a median of difference (DCA – IFCC) was 2.1 mmol/mol (IQR -0.2 – 5.1). Nevertheless DCA levels were tendentially higher than IFCC laboratory values; a U-shaped relationship has been found when comparing the IFCC values with the differences between the two methods, with major disagreements found at lower and higher HbA1c levels.

Conclusion: DCA 2000 is a valid tool in everyday practice, with good agreement with IFCC reference method. However, it should be kept in mind that disagreements increase for extreme levels in a U-shaped fashion.