Use of the Bayer DCA 2000+ for the measurement of glycated haemoglobin in a remote Australian Aboriginal community.
BACKGROUND
Good glycaemic control in type 2 diabetes can reduce both morbidity and mortality, and monitoring of glycated haemoglobin A(1c) (HbA(1c)) is currently recommended for this purpose.


METHODS
Haemoglobin A(1c) can be measured using the portable Bayer DCA 2000+. As part of a community-based screening project for chronic diseases, subjects with impaired fasting glucose concentrations or diabetes had their HbA(1c) concentration measured on the analyser. HbA(1c) measurements were also made in a laboratory using cation-exchange high-performance liquid chromatography. Results were then compared to those obtained in the field. HbA(1c) values were log(e) transformed to obtain a normal distribution.


RESULTS
Mean (95% confidence interval) HbA(1c) measured on the DCA 2000+ (n = 39) was 6.3% (5.8, 6.9%), while that measured in the laboratory was 6.5% (6.0, 7.0%). The correlation coefficient (r) between the measurements was 0.96 (P < 0.01). Bland-Altman analysis revealed that the DCA 2000+ estimate of HbA(1c) could be used interchangeably with that from the laboratory (mean bias = 0.1%, limits of agreement - 1.1, 0.8%). The sensitivity, specificity and positive predictive value of the DCA 2000+ estimate of HbA(1c) using a cut-off value of <7% for adequate glycaemic control, were all 100%.


CONCLUSIONS
The DCA 2000+ may be used to measure HbA(1c) in remote communities.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D015415:Biomarkers / Q000097:blood; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012424:Rural Population; D012680:Sensitivity and Specificity
D015415:Biomarkers; D006442:Glycated Hemoglobin