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Dr. Bill's Commentaries

Same song, second verse   (June 27, 2010)

Some of you may notice that the following story is strikingly similar to one I wrote last year: What if you have an unexpected lab value? About the only differences are the location of the meeting, and the A1C values I mention, which are slightly different this year compared to last year, and the final paragraph is different.

Here goes:

As I do every time I'm at a big diabetes meeting, I head for the exhibit hall to see what's new - and to get my A1C checked. This past weekend, I was at the American Diabetes Association meeting in Orlando, and the exhibit hall had not one, not two, but three different vendors offering free A1C testing. The vendors were using lab devices which are designed for physician office and/or patient home use, so they're not the huge ugly machines that hospital labs use, but petite machines that use a blood sample from a fingerstick, and which display an A1C result a few minutes later.

The last time I'd checked, a few months ago, my A1C had been 5.6. Things have not changed much recently, so I completely expected my results at the ADA meeting to be about the same.

But the A1C result was 6.4 - up almost a full percentage point (which is roughly equivalent to a change in blood glucose of about 35 mg/dl). Boy, was that frustrating - no matter how hard I tried, I couldn't think of a reason why it would have shot up that much.

So, off to the other vendors. The second result was 5.5. And the third result was 5.8. Very interesting (and very reassuring to me about my diabetes control!) but it certainly did make me wonder about the 6.4 value.

Next stop: to find the most knowledgeable person around at the exhibit booth which generated the high number, and talk to him/her. I did. I showed him my printouts of the three results - and asked him if he was aware of the fact his device was reading high. I presumed he'd probably bad-mouth the other companies' technology, but he totally surprised me by doing the reverse - he admitted that his company's readings were running high, and he blamed the heat in the exhibit hall the day they set up. (Different story from last year, when someone at the booth mentioned it might have been something to do with shipping, and that the company was saving some of the kits for future reassessment.)

That opens a whole new can of worms. Should a vendor continue to test people at a diabetes meeting, knowing full well that his results are "off" from where he expected? Of course not. Especially as not all people will go to the effort to get free double-checks from other vendors as I did.

And the name of the vendor with the high readings? I deliberately didn't mention it last year, but with the story being so similar this year to last, I will identify the vendor of the out-of-line device: again this year, as last year, it was the Bio-Rad "in2it A1c" device that was high. I look forward to hearing from Bio-Rad with a response to my concerns.

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Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

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