Patient-Determined Glycosylated Hemoglobin Measurements: An Aid to Patient Education

The feasibility of patient determination of fast fraction hemoglobin (HbA₁) was evaluated. In the laboratory, the fast fraction method correlated well with known mixed standards of between 0 and 40% hemoglobin A_1c (r² = 0.97, slope 1.19) and reasonably well with radioimmunoassay (r² = 0.78, slope 1.09), although prepackaged columns performed poorly about 18% of the time. Sixteen patients practicing home blood monitoring performed the determination of HbA₁ on their own blood obtained from fingerstick. Two hours of patient training were required for the procedure. The correlation of patient determination of HbA₁ with the results obtained by the laboratory on venous blood was reasonable (r² – 0.81 with a slope of 0.88). Patient performance of HbA₁ was useful in (1) providing enhanced reinforcement for self-monitoring programs, (2) engaging patients in groups in the monitoring process, and (3) providing an educational tool with which to teach pathophysiologic principles involved in diabetes mellitus.