The utility of point-of-care haemoglobin A1c tests in a very remote Aboriginal and Torres Strait Islander community: an agreement analysis with routine laboratory testing

Dissanayake, HUW; Braat, S; Gurruwiwi, G; Gulamanda, R; Tynan, JC; Marlow, L; Harrap, B; Gongnini, K; Wentworth, JM; Sanderson, L; Biggs, BA

Author(s): Dissanayake, HUW; Braat, S; Gurruwiwi, G; Gulamanda, R; Tynan, JC; Marlow, L; Harrap, B; Gongnini, K; Wentworth, JM; Sanderson, L; Biggs, BA;
Details: Publication Year 2026-10,Volume 26,Issue #4,Page 10969
Journal Title: Rural and Remote Health
Abstract: INTRODUCTION: Optimal blood glucose control is critical to the prevention of diabetes complications. Point-of-care testing (POCT) provides a flexible alternative to conventional approaches that rely on laboratory processing of venous blood samples, with variable time to receiving results. We determined the level of agreement between the A1CNow+ glycated haemoglobin POCT system and routine laboratory haemoglobin A1C (HbA1c) testing in a remote Aboriginal Australian community. METHODS: HbA1c was measured in Aboriginal and Torres Strait Islander adults using capillary blood and the point-of-care device and venous blood using standard laboratory procedures. Agreement between the point-of-care and laboratory results was examined using a modified Bland-Altman analysis and diagnostic agreement for type 2 diabetes using Cohen's kappa coefficient. Capillary and venous blood collection were conducted in a clinical setting. RESULTS: Participants (n=49) were on average age of 43±10 years, 65% were female, and with mean BMI of 30±5 kg/m2. Median HbA1c was 5.7% (39 mmol/mol) for both methods of measurement. The mean difference between the A1CNow+ point-of-care test and laboratory HbA1c measurement was 0.03% (0.34 mmol/mol), with limits of agreement of -0.75 to 0.81% (-8.15-8.83 mmol/mol). Diagnostic agreement for type 2 diabetes (HbA1c ≥6.5% (48 mmol/mol)) was moderate (Cohen's kappa statistic 0.70), with minor discrepancies observed at higher HbA1c levels. DISCUSSION: These findings support the clinical usefulness of portable HbA1c point-of-care testing beyond traditional clinic settings. While clinic-based models have improved diabetes care, they do not reach all remote communities effectively. Home-based outreach health care utilising A1CNow+ point-of-care testing may improve access to care, strengthen family engagement, and reduce cultural and logistical barriers. Despite sparse data at HbA1c levels greater than 55 mmol/mol, overall benefits appear meaningful. CONCLUSION: Capillary measurement of HbA1c using a portable point-of-care device demonstrated promising agreement with routine laboratory-tested venous blood HbA1c. This supports the development of novel outreach models of diabetes care that meet remote Aboriginal and Torres Strait Islander community needs.
Publisher: James Cook University
Keywords: Humans; Female; *Glycated Hemoglobin/analysis; Adult; *Diabetes Mellitus, Type 2/diagnosis/blood/ethnology; Male; Middle Aged; Australian Aboriginal and Torres Strait Islander Peoples; *Point-of-Care Systems; *Point-of-Care Testing/statistics & numerical data; *Health Services, Indigenous/organization & administration; Australia; Rapid Diagnostic Tests; blood glucose; point-of-care testing; type 2 diabetes; Aboriginal and Torres Strait Islander
Research Division(s): Immunology
PubMed ID: 42850901
Publisher's Version: https://doi.org/10.22605/rrh10969
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-10-12 01:25:22

Last Modified: 2026-10-12 01:25:31