THE ACCURACY OF POINT OF CARE HBA1C IN SCREENING FOR TYPE 2 DIABETES IN ASYMPTOMATIC ADULTS: META-ANALYSIS

Background: Diabetes Mellitus represent a major health problem of the 21^st century, according to International Diabetic Federation (IDF), three of the Arabian Gulf countries have the highest prevalence of type 2 diabetes worldwide including Saudi Arabia. Screening for diabetes mellitus by using HbA1c point of care devices is a new quick and relatively cheap method.

Objective: To collect and combine the available data about the correlation between point of care HbA1c (POC HbA1c) testing and laboratory HbA1c measurement in screening for asymptomatic adult participants for type 2 diabetes.  

Method: We searched databases for studies addressing the correlation between point of care HbA1c in the screening of type 2 diabetes and laboratory HbA1c measurement (reference method), for asymptomatic adult participants. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). Screening accuracy measures were pooled using the random-effects model and subgroup, and sensitivity analyses were conducted. 

Results: Out of 11919 studies identified, only 4 met the eligibility criteria. Three POC HbA1c devices were reviewed in this analysis: A1cNow+, Afinion, and Que-test devices.

The included studies have a moderate risk of bias, and the pooled results showed a strong positive correlation between POC HbA1c testing and laboratory HbA1c measurement (correlation coefficient, 0.935; 95% confidence interval, 0.893–0.961); however, there is substantial heterogeneity.

Conclusion: The pooled results showed a strong positive correlation between point of care HbA1c devices and standard laboratory HbA1c method in screening for type 2 diabetes.

Key words: Screening, Type 2 Diabetes Mellitus, Glycemic control, HbA1c, Point of Care (POC), A1cNow+,   Afinion, and Que-test, Meta-analysis