Effect of point-of-care on maintenance of glycemic control as measured by A1C.

A lthough most diabetes management guidelines (1–3) suggest that physicians measure A1C, it is extremely difficult to have results available before a physician’s evaluation of the patient. As such, point-of-care (POC) A1C is thought to be useful since it is assumed that rapid result availability will enhance diabetes care by increasing education and ensuring appropriate changes to therapy while the patient is being evaluated by a physician. This is indicated by a number of studies (4–7) that have found that POC was associated with a significant reduction in A1C. These studies, however, followed patients for 12 months, and the impact of POC A1C beyond the study period was not addressed. Recently, it was reported that the availability of POC A1C had no impact on the management of diabetic patients (8), and the lack of an effect could be explained by the fact that active treatment was based on achieving blood glucose rather than A1C targets or, possibly, the poor precision of the specific POC A1C method used (9). In 2001, the University of Texas Medical Branch opened the Stark Diabetes Center to give specialized diabetes care. After the 1st year, POC A1C testing was introduced, allowing us to conduct a cross-sectional retrospective study to determine what, if any, impact POC testing had on A1C levels over the subsequent 3.5 years.