Diabetes mellitus non-glucose monitoring: point-of-care testing.
OBJECTIVE
To review and evaluate reimbursable point-of-care testing devices yielding immediate results, other than glucometers, that are available to evaluate and monitor diabetes and its complications and to describe how pharmacists may use these devices.


METHODS
A MEDLINE search (1966-March 2003) was performed using the following search terms: point-of-care systems, clinical diabetes monitoring, decision support systems, glycosylated hemoglobin, and microalbumin. Pertinent company and product Web sites and customer service departments were accessed for information about point-of-care devices and supplies.


METHODS
All descriptive, evaluative, and comparative articles and product information were reviewed, and relevant information was included.


RESULTS
Diabetes mellitus is a complex, chronic metabolic disease that is a challenging management problem and requires routine monitoring for disease control and screening for complications. Point-of-care tests are available to monitor hemoglobin A(1c), glucose, fructosamine, ketones, lipid profiles, urinary microalbumin concentrations, and alanine aminotransferase concentrations. Many of these tests are Clinical Laboratory Improvement Amendments (CLIA)-waived and, therefore, practical for pharmacists to use in a variety of settings. Tests for measuring sensation are also discussed. Pharmacists should consider each of these tests in the establishment of a comprehensive diabetes care service.


CONCLUSIONS
The availability of many new point-of-care testing methods creates new opportunities for pharmacists to monitor drug therapy and screen for complications in patients with diabetes. Reimbursement is possible since many of these tests are CLIA-waived.
Armor
Becky L
BL
Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 1110 N. Stonewall, Oklahoma City, OK 73117-1223, USA. becky-armor@ouhsc.edu
Britton
Mark L
ML
D000419:Albuminuria / Q000175:diagnosis; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D006403:Hematologic Tests / Q000295:instrumentation / Q000379:methods / Q000592:standards; D006801:Humans; D008111:Liver Function Tests / Q000295:instrumentation / Q000379:methods; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D010593:Pharmaceutical Services; D019095:Point-of-Care Systems