A1C Lecture

Question 1

A1C or HbA1C

Used to diagnose and monitor __________

Blood test that gives you an average of blood glucose over the past __________ months

Glucose attaches to hemoglobin on red blood cells

Test _________ in patients without managed diabetes; check _________ in patients with managed diabetes

Answer 1

diabetes

2-3 month

quarterly

biannually

Question 2

Diagnosing Diabetes
Fasting plasma glucose (FPG) ≥_______mg/dL
2 hour post plasma glucose (PG) ≥______mg/dL during OGTT
A1C ≥ ______%
Classic hyperglycemic symptoms or a random PG ≥
200 mg/dL

Answer 2

≥126mg/dL
≥200 mg/dL
≥ 6.5%

Question 3

A1C Goals
The goal for most
patients:
A1C______
FBG ______ mg/dL
PPG <180 mg/dL

Answer 3

<7%
80-130 mg/dL

Question 4

AC1 goals

Depending on the provider and patient preference, goals can
more (<6.5%) or less (<8%) stringent

Question 5

Why test an A1C?
Assessment of glycemic control
Has a strong predictive value for ______________-
Chronic kidney disease
Diabetic retinopathy
Diabetic peripheral neuropathy
Cardiovascular disease

Adjusting __________ therapy
Pharmacotherapy
________choices
___________ activity

Answer 5

glycemic control

diabetes complications

treatment therapy

food choices

physical activity

Question 6

A1CNow
~$50 per kit (professional kits >$150)
Measures A1C using _______ or _______ whole blood (need 5 microliters)
Results are presented in 5 minutes
Each box includes:
1 patented A1CNow analyzer
Test cartridges
Finger-stick lancets
Blood collectors

Not used for the diagnosis of diabetes, nor is a substitute
for routine care with your health care provider

Answer 6

capillary

venous

Question 7

OGTT=oral glucose tolerance test

Question 8

Using A1C Sample Collection
1) Use your own lancet device to draw blood. Gently touch blood drop fill. Fully insert blood collector into shaker body. Twisting motion helps. Shake _______times vigorously. This will mix the blood with the blood solution

Wait for SMPL to display. Ready for shaker. Wait for SMPL to appear on display before adding sample. This indicates the interal quality checks have been successfully completed. Remove base from shaker body. Push firmly down on shaker keep the shaker vertical. Removal quickly. Do not move or handle analyzer until test is complete.

Important notice: It is very important to add the sample in one motion.

After a 5 minute countdown, the analyzer will display 3 messages:
QC test result (QCOK)
A1C result (4-13%, A1c or 20-120mmol/mol)
Number of tests left (for example 01TL)
The A1C result and number of tests remaining will be displayed for 15 minutes or until the next test catridge is inserted.

Important note: if QCOK is not displayed, please contact Customer Service or consult the troubleshooting guide.

Remove

Answer 8

6-8 times

Question 9

Cartridge Preparation

DO NOT open foil punch until this step. Use within 2 minutes of opening. If foil pouch is damaged, DO NOT USETear foil pouch open at t the notches at the sides.

Question 10

Using A1CNow Analyzer Quality Check

Wait for SMPL to appear on display before adding sample. This indicates the internal quality checks have been successfully completed.

Question 11

Using A1CNow

Applying the sample
Remove base from shaker body. Push firmly down on shaker, keeping the shaker vertical. Remove quickly. Do not move or handle analyzer until test is complete.

Important Note: It is very important to add sample in one motion

Question 12

Using A1CNow
Reading Results
After a 5 minute countdown, the analyzer will display three messages:
QC test (QCOK)
A1C result (4-13% A1C or 20-120mmol/mol)
Number of tests left (for example 01TL)

The A1C result and number of tests remaining will be displayed for 15 minutes or until the next test cartridge is inserted.

Important note: If QCOK is not displayed, please contact Customer Service or consult the troubleshooting guide.

Question 13

A1CNow

Disposing of Test Cartridge

Remove the cartridge and dispose of it in accordance with your biohazard procedures.

Important notes:
The analyze is reusable. Do not discard.

The analyzer will not perform any tests after the programmed number of tests have been run. (00TL indicates that all programmed tests have been used)

Question 14

A1CNow Counseling

Store at room temperature or in the refrigerator
**Remove from refrigerator 1 hours before testing allowing it to become __________)

A1c analyzer must be used with only contents of the original kit-verify LOT numbers on each product match the LOT number on the analyzer

Leave all components sealed in pouches until use

Wash hands before performing the test

Complete the test from beginning to end in __________

Fill blood collector to indicated line

Do not touch meter during the _______minute wait period

A1CNow does not store A1C readings

Answer 14

room temperature

15 minutes

5 minute

Question 15

Limitations for A1C
Hemolytic and other anemias

________cell disease

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Recent ________transfusion

Drugs that stimulate RBC production

End-stage ______disease

Pregnancy

Answer 15

Sickle cell disease

Recent blood transfusion

End-stage kidney disease

Question 16

A1CNow
Accuracy -0.6%+0.5%
Genetic variations in hemoglobin (HbS, HbC, HbF) or high levels of rheumatoid factor could affect accuracy
Displays A1C results between 4-13%
Not used for the screening or diagnosis of diabetes, nor is a substitute for routine care with your health care provider

Question 17

Who would benefit from A1CNow?

Patients with financial barriers
No _________
High __________

Patients who are struggling to meet ________ goals
Motivational
Most insurance companies will only cover 1 test once every 3 months

Patients whose treatment plan recently ____________
~50% of A1C is from the past 30 days
~25% of A1C is from past 30-60 days
~25% of A1C is from past 60-90 days

Answer 17

no insurance

high deductibles

glycemic

changed