HBA1C POINT-OF-CARE TESTING FOR DIABETES CONTROL IN A LOW- INCOME POPULATION: A BEFORE AND AFTER STUDY

The objective of this study is to evaluate a Point-of-Care (POC) HbA1c testing program to help control glycemic levels of diabetic patients in a low-income area of Minas Gerais, Brazil. Patients between 30 and 69 years-old were enrolled in this naturalistic before and after interventional study. The results were measured in terms of the rate of HbA1c tests, time between appointments, and HbA1c Results: The sample was divided in four groups: (i) patients only with POC HbA1c data; (ii) patients only with conventional HbA1c data; (iii) patients with both; and (iv) patients with neither. The analysis considered three periods: A, before the intervention; B, during the intervention and before the pandemics; and C, during the pandemics. A comparative analysis of costs was conducted under the perspective of the society. In total, 1,349 patients were included. The average age of the sample was 54.91 (SD=9.23) and the average BMI was 29.50 (SD=5.68). Most patients had type-II diabetes (98.7%) and were female (70.3%). The rate of consultation was significantly different between all periods and groups of patients. Notably, group (iii) has a much higher consultation rate. The second time period (B) is also associated to a higher consultation rate, suggesting that the project improved access. We could not demonstrate a significant difference in the values of HbA1c between the periods. The cost associated with the tests were around 89.45 PPP-USD for POC tests and between 32.44 and 54.66 PPP-USD for conventional tests. We can conclude that the use of the POC device improved access to HbA1c testing, although we could not observe an improvement of the glycemic control. This last result should be analyzed with discretion due to the short follow-up and the pandemic context. The costs associated with the POC HbA1c tests were higher than the costs of the conventional tests.