Haemoglobin A1c determination from dried blood spots prepared with HemaSpot blood collection devices: comparison with fresh Capillary blood

Aims
HbA1c monitoring in the Scottish Highlands is by HPLC analysis of GP collected venous samples at a centralised laboratory. Availability of HbA1c results at clinic appointments is less than ideal due to patient reticence and availability/timeliness of appointments. This study assessed the clinical performance and patient acceptance of HemaSpot™ blood collection devices as an alternative blood collection method.
Methods
Adult men and women with any type of diabetes, routinely carrying out self-monitoring of blood glucose were recruited (n=128). Participants provided a venous blood sample and prepared two HemaSpot™ dried blood spots (DBS), one at clinics and one at home. HbA1c analysis was by TOSOH G8 HPLC. Participants also completed a questionnaire.
Results
A strong linear relationships between HbA1c levels in dried blood spots and venous blood were observed and a linear model was fitted to the data. Time between dried blood spot preparation and testing did not impact the model.
Participants were accepting of the approach, 69.2% would use this system if available and 60.7% would be more likely to use this system than going to their GP.

Conclusions
The combination of a robust desiccating dried blood spot device, home sample preparation and return by post produces HbA1c data which supports use of a time-independent linear calibration of dried blood spot to venous blood HbA1c. A robust remote sample collection service would be valuable to people living with diabetes in urban areas who are working or house-bound as well as those living in remote or rural locations.