Point-of-care HbA1c in clinical practice: caveats and considerations for optimal use
Open accessAbstract
Hemoglobin A1c (A1C) is widely used for the diagnosis and management of diabetes. Accurate measurement of A1C is necessary for optimal clinical value. Assay standardization has markedly improved the accuracy and consistency of A1C testing. Devices to measure A1C at point of care (POC) are commercially available, allowing rapid results when the patient is seen. In this review, we describe how standardization of A1C testing was achieved, leading to high-quality results in clinical laboratories. We address the use of POC A1C testing in clinical situations and summarize the advantages and disadvantages of POC A1C testing. We emphasize the importance of considering the limitations of these devices and following correct testing procedures to ensure that accurate A1C results are obtained for optimal care of patients.
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Point-of-care A1C testing can offer timely opportunities for treatment adjustments during appointments with health care professionals, although point-of-care tests may be less accurate than laboratory A1C assays.
“Point-of-care A1C testing can offer timely opportunities for treatment adjustments during appointments with health care professionals, although point-of-care tests may be less accurate than laboratory A1C assays (5).”
From 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026. (2026) · cites this paper as [5]
A previous meta-analysis noted a non-significant trend toward less negative bias over time for the DCA device (coefficient 0.01% HbA1c per year; P=0.081), with no significant temporal effect for other devices.
“This observation aligns with a previous meta-analysis which noted a non-significant trend toward less negative bias over time for the DCA device (coefficient 0.01% HbA1c per year; P=0.081), suggesting possible calibration improvements, although no significant temporal effect was observed for other devices (10,36,37).”
From Comparison of point‑of‑care HbA1c devices with laboratory HPLC methods: A systematic review and meta‑analysis (2026) · cites this paper as [36]
The section ‘POC A1C Testing Is Less Accurate Than Laboratory Testing’ summarizes a meta-analysis of device bias, but does not report a DCA-specific trend over time, a coefficient of 0.01% per year, P=0.081, or temporal results for other devices. Searches for those terms found no passage addressing the claimed temporal analysis. (LLM, conf=0.70)
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References 48 · Cited by 29
- Authors
- Sacks, D. B., Kirkman, M. S., & Little, R. R.
- Affiliations
- National Institutes of Health (US)
- University of North Carolina at Chapel Hill (US)
- University of Missouri (US)
- Corresponding author
- Sacks, David B.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2024-03-29
- Volume
- 47
- Issue
- 7
- Pages
- 1104-1110
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC11208753
- OpenAlex
- W4393305335
- Cited by
- 29
- References
- 48
- Citations by year
- 2026: 14 · 2025: 12 · 2024: 3
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH Clinical Center (Intramural research grant)
- National Institutes of Health (5U01DK133106-02)
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- HbA1c, point-of-care testing, diabetes management, assay standardization, clinical laboratory testing, diabetes diagnosis
- MeSH terms
- Diabetes Mellitus, Glycated Hemoglobin, Humans, Point-of-Care Systems
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