Volumetric absorptive microsampling at home as an alternative tool for the monitoring of HbA1c in diabetes patients

Abstract

Utilizing equipment standard available in the clinical laboratory, the use of home-sampled dried VAMS and DBS is not a reliable tool for the monitoring of HbA1c. However, perfect agreement between HbA1c measured on wet VAMS and capillary microsamples was obtained.

Dried blood spots in therapeutic drug monitoring and toxicology

“…[4][5][6]12]. Also (bio)markers such as HbA1c can be followed up via dried blood microsamples [15]. However, it needs to be mentioned that routine implementation in clinical laboratories has remained limited so far [12].…”

“…Moreover, in those cases, sampling will typically be performed in a hospital setting, where it would actually not be logical to choose a DBS approach (needing to wait for a sample to dry). Yet, even in a hospital context, the sampling itself may offer opportunities or advantages, as exemplified by, for example, HbA1c monitoring of 'wet' capillary blood samples [15]. In general, the choice for DBS sampling and analysis needs to be well-balanced, taking into account the clinical question and the context in which sampling and analysis need to take place.…”

Comment on HbA1c determination from HemaSpot blood collection devices: comparison of home‐prepared dried blood spots with standard venous blood analysis

“…Because we used the same equipment as the authors (a Tosoh-G8 analyser), we know that this system struggles with the haemoglobin conversions that inherently take place in dried samples, leading to deviating profiles. More specifically, we observed that samples analysed within 3 days showed greater agreement with venous samples than samples analysed after 4-6 days [2].…”

“…However, from a clinical perspective, objective acceptance criteria should be taken into account to evaluate the agreement (rather than correlation) between HbA 1c results obtained from DBS and those obtained from venous blood. For example, in our study [2], we used Royal College of Pathologists of Australasia (RCPA) quality requirements, which state that if the target HbA 1c is ≤ 86 mmol/mol (10.0%), the allowable error should be within AE 4 mmol/mol (0.5%). If the target HbA 1c result is > 86 mmol/mol (10.0%), the measured value on DBS should be within AE 5% relative to the target value [3].…”

“…In our (Belgian) experience it was not possible to receive all the samples in the laboratory within 4 days after collection when using standard postal services (e.g. at weekends or holidays) [2,5]. Because we used the same equipment as the authors (a Tosoh-G8 analyser), we know that this system struggles with the haemoglobin conversions that inherently take place in dried samples, leading to deviating profiles.…”