Testing your A1c from home
My latest video shows how I used the Diabetech HomeCheck A1c test kit to test my A1c at home.This is the second time I've used this kit to check my A1c levels. Total cost for the kit is $35.34 including shipping to my home and shipping the test sample back to the Diabetech labs.
In the video I show how to use this simple kit. In the video I mention a form that needs the test date not your birth date. My mistake.
I mailed the test to Diabetech on Tuesday and last night, 3 days later, I got the results back my e-mail (I can also ask for them by postal mail) and they showed my A1c had improved from 7.6% in November to 6.8% in May. It's a great improvement and I really like that I can do this so easily at home. Total time from ordering the kit to getting the results was 10 days. Pretty good and I really liked the results I got.
Full disclosure: Kevin McMahon, the CEO of Diabetech, is a blogging acquaintance of mine. I've paid in full for both these tests and did this review without being asked to by Kevin. I like the product and admire the work that Diabetech has done to make diabetes management easier.
Labels: A1C, care, diabetes, homecheck
posted by Bernard @ 8:38 PM
10 Comments:
My daughter was disagnosed late January 2008. She is 9 and has done her first A1C which was 7. What is your regime to get below 7. Are you pumping, strict low carb diet, running marathons ? Bernard many thanks for the info you provide. You have no idea how helpful your info has been for a parent grasping for answers.
Peter
Wow! testing A1c's at home!!! Amazing...
Bernard... great video. Thank you! I have a question... any explanation on why they have to take an entire tube of blood at the lab/doc's office, and this test only needs a small drop for the sample? Just curious. Also, are these tests as accurate as the ones done in the doctor's office? What's the margin of error? Thanks dude! Always love reading your blogs!
Hi Windy,
Bernard asked me to weigh in here on your question.
First off, anything having to do with labs is very complex to do and even harder to explain.
With that said, here goes:
You have probably seen that 'stuff' in the bottom of the venipuncture vial. It's usually kind of yellowish. You have probably also noticed that there are different sized vials they use when drawing blood via your vein.
That yellow 'stuff' has 'things' in it that correspond to the volume of blood needed to fill the vial. If you don't put enough blood in the vial then the ratio of 'things' to blood is off and if you put too much blood in then the red blood cells will shrink and .... you get the picture .... all bets are off.
The other thing to know is that these vials (aka giant test tubes) are part of a standardized machine process. If you ever get a chance to tour a lab do it and you won't ever trust a lab result again as long as you live. It's quite a high volume deal.
The HomeCheck has its own 'stuff' inside its vial calibrated to the amount of blood drawn by the cuvette (aka 'plastic thingamajig that wicks blood from your finger').
Simply said, our process is different - our test - our process. We don't have to fit into the requirements of a high volume (testing everything) process. And we're specialized (aka obsessive) and only look at blood on the way to delivering the most accurate A1c possible.
HomeCheck has been clinically validated to being within +/-0.1 of the true A1c and we regularly pass blind test samples sent to us by the College of American Pathologists for what is called Proficiency Testing (aka PT).
HomeCheck is not only accurate but also precise. For more on what this means you might want to go to ChallengeDiabetes.com and research it more (or you might prefer sticking pins in your eyes). The choice is yours.
Thanks for asking, too. ;)
Kevin- Thanks so much for the great response in lay-person language. =) I actually decided to order my first HomeCheck test yesterday. Can't wait to try it out! -Windy
Bernard, you're a brave soul for taking one on the fingertip for the sake of showing us how this works. Ow! :) Seriously, though, I find it amazing that a home A1C test can actually be that accurate, since so many lab machines aren't calibrated correctly. We're a long way from the days of test tubes and fizzy tablets ;)
Araby62 - excellent point. You are correct that we place too much faith in the resulting # and don't question how we got there. That goes for just about all diagnostics.
In the case of bg or a1c by home meter w instant results - there is no lab and therefore a much higher variability in the result - no way to apply serious quality control. Even with the in-office machines, many of the operators are not laboratorians and therefore don't calibrate or handle like they should. For example, one known risk is for the operator to improperly handle the cuvette for the DCA2000 with their fingers. The oil from the fingertip will skew the A1c result since the light passing through the glass isn't expecting the oil...
In the average lab, results depend entirely upon the method, the operator and the quality of the sample. Also hard to manage.
With HomeCheck's hematology screening and then the %A1c determination, the process has been designed to control all of these variables including a specialty lab focused on the getting the right number and we have the Proficiency Test results from the College of American Pathologists every 6 months to make sure that we're always the best way to get the most accurate A1c.
This sounds great. And thanks to Kevin for the excellent, informative and direct responses. Do either of you (or anybody else) have any comments or feedback on some of the other A1c home testing products? For example, after I read your blog I did a quick search and found two other options: A1cNow by Metrika, and A1c At-Home by FlexSite Diagnostics. Not to suggest that the HomeCheck test isn't worth every penny of the reasonable cost but these other options cost even less. (Significantly less.) I be curious to know whether there is reason to think their results are any less precise than Homecheck's. TIA.
Oops, sorry. Upon second reading I see that Kevin did partially answer part of my question regarding the A1c Now home meter. Thanks. But I'd still appreciate any further analysis or discussion regarding all the A1c home test options available to us. Thanks again.
Hi PG-13,
Great question. You get what you pay for!
You can pick up some great insight over at childrenwithdiabetes where we have many customers - just read what they have to say incl some clarification on my end.
http://forums.childrenwithdiabetes.com/showpost.php?p=183512&postcount=14
Things to consider are:
- ease of use / convenience
- sample stability (how long is the sample viable)
- ability of the test to detect hemoglobin variants (only HomeCheck)
- variability
- accuracy
Like I've said before, any test can give you a number. However, when you're dealing with A1c, you only have one shot at getting the right answer so it's probably worth going the extra mile especially when the wrong answer can have devastating consequences.
Other research can be found here:
Why HomeCheck (HPLC multi-method) is a better lab test vs immunoassay method:
http://journal.diabetes.org/clinicaldiabetes/V18N42000/pg179.htm
Problems with other A1c instant devices and also highlighting inaccuracy of DCA2000:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1978195
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