The utility of point-of-care haemoglobin A1c tests in a very remote Aboriginal and Torres Strait Islander community: an agreement analysis with routine laboratory testing.

Authors

Hasthi Udyangani Wanamali Dissanayake, Sabine Braat, George Gurruwiwi, Ruth Gulamanda, Josh C Tynan, Lindy Marlow, Benjamin Harrap, Kenny Gongnini, John M Wentworth, Lou Sanderson, Beverley-Ann Biggs, CLAN study group

Published in

Rural and remote health. Volume 26. Issue 4. Pages 10969. Epub Oct 05, 2026.

Abstract

Optimal blood glucose control is critical to the prevention of diabetes complications. Point-of-care testing (POCT) provides a flexible alternative to conventional approaches that rely on laboratory processing of venous blood samples, with variable time to receiving results. We determined the level of agreement between the A1CNow+ glycated haemoglobin POCT system and routine laboratory haemoglobin A1C (HbA1c) testing in a remote Aboriginal Australian community.
HbA1c was measured in Aboriginal and Torres Strait Islander adults using capillary blood and the point-of-care device and venous blood using standard laboratory procedures. Agreement between the point-of-care and laboratory results was examined using a modified Bland-Altman analysis and diagnostic agreement for type 2 diabetes using Cohen's kappa coefficient. Capillary and venous blood collection were conducted in a clinical setting.
Participants (n=49) were on average age of 43±10 years, 65% were female, and with mean BMI of 30±5 kg/m2. Median HbA1c was 5.7% (39 mmol/mol) for both methods of measurement. The mean difference between the A1CNow+ point-of-care test and laboratory HbA1c measurement was 0.03% (0.34 mmol/mol), with limits of agreement of -0.75 to 0.81% (-8.15-8.83 mmol/mol). Diagnostic agreement for type 2 diabetes (HbA1c ≥6.5% (48 mmol/mol)) was moderate (Cohen's kappa statistic 0.70), with minor discrepancies observed at higher HbA1c levels.
These findings support the clinical usefulness of portable HbA1c point-of-care testing beyond traditional clinic settings. While clinic-based models have improved diabetes care, they do not reach all remote communities effectively. Home-based outreach health care utilising A1CNow+ point-of-care testing may improve access to care, strengthen family engagement, and reduce cultural and logistical barriers. Despite sparse data at HbA1c levels greater than 55 mmol/mol, overall benefits appear meaningful.
Capillary measurement of HbA1c using a portable point-of-care device demonstrated promising agreement with routine laboratory-tested venous blood HbA1c. This supports the development of novel outreach models of diabetes care that meet remote Aboriginal and Torres Strait Islander community needs.

PMID:
42850901
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

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