HbA1c where and when the patient needs it
By Michelle Cleaver, Point of Care Testing Product Manager, Una Health
Diabetes affects a significant number of people in the UK, as over 4.3 million individuals are currently living with the condition. Additionally, it is estimated that 850,000 people could be living with diabetes who are yet to be diagnosed.1
Unmanaged and poorly controlled diabetes can lead to numerous chronic complications, such as retinopathy, nephropathy, neuropathy, stroke, heart attack, gum disease, diabetic foot, and increased chance of some cancers and sexual problems2.
National Institute for Health and Care Excellence (NICE) recommends that for the management of both type 1 and type 2 diabetes, HbA1c is measured every 3-6 months until the patient is stable. Then every 6 months for life, to limit progression onto chronic conditions. For this to happen diabetes clinics need the engagement of their patients.
Data published by NHS England in 2019 estimated that non-attendance at out-patient follow up appointments including diabetic clinics is 8%3.
A very interesting example is presented by Dr Dan Alton, a GP in Berkshire and Population Health Management clinical lead for West Berkshire CCG, in a recent Podcast – “A better understanding of Population Health Management“4.
Dr Alton looked to glean insight from data into why his patients were not attending diabetes clinics. It is easy to jump to a conclusion why a patient does not engage in the management of their diabetes. Dr Dan Alton looked at different cohorts to investigate why certain patients did not attend their appointments. What he found out is that it’s not a one size fits all approach.
There are multiple factors that could prevent attendance. From his research, he learned that one group were of working age in a high commuter area. They did care about their health, but struggled to attend appointments due the constraints of train-times/commuting. Another cohort were of foreign nationality, so struggled with the language barrier and culture of individual appointments. Through this research he was able to schedule clinics to address these issues, increasing the attendance.
A more flexible approach in HbA1c testing
Point of care analysis enables a more flexible approach by taking the test to the patient and reduce the number of times the patient has to interact with the healthcare system in the management of their health.
The QuikRead go® serves as a compact and portable immunoassay analyser that can take the HbA1c test to where it is needed. The HbA1c method is IFCC certified, a requirement of NICE guidelines5. This allows NICE-recommended analysis exactly where and when a patient needs it. In turn, it can help prevent the complication of Diabetes which occur through poor management.
By looking closely into the data of patient non-engagement and taking HbA1c to where the patient needs it, the NHS can save thousands of pounds and improve the lives of 4.3 million people with Diabetes6 by preventing progression to expensive chronic condition.
References and further reading:
- Diabetes UK, How many people in the UK have diabetes?, https://www.diabetes.org.uk/professionals/position-statements-reports/statistics
- Diabetes UK, Complications of Diabetes, https://www.diabetes.org.uk/guide-to-diabetes/complications
- Researchgate, Non-attendance at diabetes outpatient appointments: a systematic review, https://www.researchgate.net/publication/338067953_Non-attendance_at_diabetes_outpatient_appointments_a_systematic_review
- Ockham Healthcare, Podcast – Daniel Alton – A better understanding of Population Health Management – https://ockham.healthcare/podcast-daniel-alton-a-better-understanding-of-population-health-management/
- NICE, Type 2 diabetes in adults: management, NICE Guideline [NG28], https://www.nice.org.uk/guidance/ng28/chapter/recommendations
- Diabetes UK, Number of people living with diabetes in the UK tops 5 million for the first time, https://www.diabetes.org.uk/about_us/news/number-people-living-diabetes-uk-tops-5-million-first-time
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The new generation point-of-care system, designed to support diagnosis and treatment management at various types of healthcare sites including community care.