2023 · Diabetic medicine : a journal of the British Diabetic Association · paywalled
Home monitoring of haemoglobin A<sub>1c</sub> in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability
Colley et al.
The finding, in our words
Capillary blood collected in microtubes yielded HbA1c results that agreed closely with venous sampling, while dried blood spots showed markedly poorer agreement. High patient acceptability and willingness to repeat suggest microtubes are a viable option for decentralised diabetes monitoring.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Dried VAMS and DBS samples collected at home and analysed after a median of three days showed poor agreement with standard venous or capillary blood for HbA1c monitoring. In contrast, wet VAMS samples analysed immediately demonstrated excellent agreement, indicating that sample drying and delayed analysis compromise reliability for decentralised HbA1c measurement.
In a cohort of 62 participants evaluating home self-collection with the TassoPlus device, 38 returned samples, with 29% excluded due to insufficient plasma volume below 200 ΔL. Although viral load measurements in adequate samples correlated well with conventional testing (r = 0.800), the high failure rate and missed detection in low-volume viremic samples indicate that further technical refinements are necessary before clinical adoption.
Home DBS sampling gave testosterone results that agreed well with venous blood in men on intramuscular testosterone undecanoate, but showed falsely high values in those using topical gel, likely from skin contamination. Patients preferred home collection for its convenience, suggesting DBS is viable for decentralised monitoring of injectable testosterone if patients are taught proper technique.
This meta-analysis found strong agreement between self-collected capillary blood and venous samples for laboratory results. Capillary sampling was associated with significantly lower pain scores than venipuncture, particularly when using upper arm devices rather than fingerprick methods.
Dried blood spot sampling matched venous serum performance for islet autoantibody detection and was considered minimally invasive and convenient by parents and stakeholders, supporting its use for decentralised screening in home or community settings.