At-home A1c Tests

We received quite a few questions from readers since the debut of our TalkBack column in the previous issue of diaTribe. Here’s one from a reader interested in at-home A1c test kits. We sent it off to diaTribe advisory board member, Dr. Barry Ginsberg MD, PhD, the CEO of Diabetes Technology Consultants for his take.

Question:

Hi Kelly,

I am very interested in finding out more about in home A1c test kits. Do you have any information on them? How reliable they are vs. a whole blood test that you would get in a lab/doctors office? Why am I interested vs. going to the lab? My wife and I live on a sailboat traveling up and down the US East Coast and Bahamas. We are about to set sail for Bermuda (followed by sailing to the Caribbean) any day from the mouth if the Chesapeake. As a result, finding a lab, much less having a doctor’s order to get a test is problematic at best.

I just found two types, but will not have a chance to get them and try them out before leaving. When we get to the Caribbean, I may be able to have someone mail one or both types to me.

From what I see so far, they basically require a finger-stick and then you mail the dried blood sample back to a lab. The lab interprets the results and then sends you and your doctor the results. Cost appears to be in the $20 - $25 range.

Thanks in advance. Love the DiaTribe website. It is so great reading about others who wrestle with the real-life issues associated with managing the highs & lows of BG along with everything else life throws at us.

Response from Dr. Barry Ginsberg:

The home A1c tests are generally accurate and most have NGSP (National Glycohemoglobin Standardization Program) accreditation—that is, they are reasonably accurate and can produce results with values equivalent to the DCCT (a landmark trial investigating the relationship between A1c and diabetes complications).

They are less accurate and precise than the expensive laboratory instruments found in a reference laboratory, but accurate enough and about as accurate as the tests the doctors do in their own offices.

If you use one of these tests you should use the values as comparators, not as absolute. It is a good idea the first time to do a lab test at the same time. Then, follow up and make sure future tests don’t rise, but rather stay the same or fall.