A pilot study by Dr. Poyap James Rooney, MBBS, MMed Candidate 2014
Dr. Mere Kende – Head of Pathology – UPNG, SMHS
Dr. Francis Bannick – Pathology coordinator – Port Moresby General Hospital
Dr. Steve Andersen – External Examiner
The HbA1c test has been used since the mid 1980’s and is now universally accepted as the most reliable means of monitoring long-term glycaemic control and has become indispensible in any modern diabetes clinics.
More recently the usage of HbA1c as a diagnostic tool has been accepted by several large organisations including the American Diabetes Association (ADA), International Diabetes Federation (IDF) and the WHO.
Considering all the advantages and disadvantages of the use of HbA1c the WHO recommendation is that:
“HbA1c can be used as a diagnostic test for diabetes providing that stringent quality assurance test are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement”.
Aim of the study
The aim of this study is to assess the performance of the HbA1c as a diagnostic test for diabetes in comparison with the fasting blood glucose test.
Screening of individuals will be done at Port Moresby General Hospital and several major business houses in Port Moresby. Individuals who have never been diagnosed previously with diabetes mellitus and who are identified as having either unequivocal diabetes or those that require a 2nd test on a different occasion to either confirm or rule out diabetes will be recruited for the study. These individuals will have a spot HbA1c test done using the Afinion AS100 analyser and a mutually agreed time and place will be arranged to perform a fasting blood glucose test.
Individuals who have discrepant result between the HbA1c and the Fasting Blood Glucose for the diagnosis of diabetes will have an oral glucose tolerance test (OGTT) (used as a gold standard) to confirm and the results will be used to further assess the performance of the tests.
The different test will be correlated against each other and the performance of HbA1c as a diagnostic test assessed. This is a pilot study and will form the basis of a much larger population study in the near future. It is also hoped that this study will spur a renascence of diabetes research in the country which has seen paucity in the last decade