SAT-150 Usefulness of Point-of-Care Testing as a Tool in the Management of Patients with Diabetes

Abstract D.M. Nascimento: None. G.M. Chichelero: None. L.R. Bahia: None. F. Malerbi: None. B.D. Schaan: None. Background: The use of technologies that allow the identification of chronic complications of diabetes mellitus and glycemic control, especially in areas with limited access to healthcare services is crucial for an early intervention and, consequently, for improving the quality of life. The application of point-of-care testing (POCT) for this purpose enables analyses outside the laboratory setting, ensuring real-time availability of results, thus assisting in decision-making. For this, it is necessary to assess its accuracy to avoid erroneous clinical decisions. Objective: To identify potential differences between POCT and laboratory hemoglobin A1c (HbA1c), creatinine (CREA), and albumin to creatinine ratio (ACR) in outpatients with diabetes. Methods: This is a cross sectional study, in which HbA1c and CREA were evaluated simultaneously in capillary and venous blood samples from patients with diabetes mellitus randomly selected from tertiary and primary care healthy units, by POCT (AfinionTM 2 Analyzer, Abbott Diagnostics Technologies AS, Oslo/Norway and i-STAT 1 Analyzer, Abbott Point of Care Inc., Ontario/Canada) and laboratory method (VariantTM II Turbo HbA1c Kit - 2.0, Bio-Rad Laboratories, Inc. California/USA and Alinity c System, Abbott Ireland Diagnostics Division, Longford/Ireland). Urine samples were also obtained and evaluated by POCT (AfinionTM 2 Analyzer, Abbott Diagnostics Technologies AS, Oslo/Norway) and laboratory method (Alinity c System, Abbott Ireland Diagnostics Division, Longford/Ireland). The intraclass correlation coefficient (ICC) was performed to calculate the inter-rater reliability for continuous variables and the Fleiss' Kappa coefficient (k) was used for categorical variables. Results: A total of 261 patients were included. Overall, participants were aged 65 ± 12.3 years, mainly women (53,6%), white (n = 205, 78.5%), with type 2 diabetes (n = 236, 90.4%), laboratory HbA1c > 7% (63,7%), and ACR < 30 mg/g (66.4%). The mean POCT and laboratory HbA1c was 7.9 ± 1.8 % and 7.8 ± 1.8%, respectively. The mean POCT and laboratory CREA was 1.0 ± 0.8 mg/dL and 1.1 ± 0.7 mg/dL, respectively. ACR was categorized in normal (< 30 mg/g) or increased (≥ 30mg/g). Agreement was high for HbA1c (ICC = 0.98), CREA (ICC = 0.99), and ACR (k = 0.96). Conclusion: Point-of-care testing demonstrated almost perfect agreement in assessment of glycemic control and renal impairment in patients with diabetes mellitus as compared to the gold standard laboratory method. Support: FAPERGS, FIPE, Brazilian Society of Diabetes Saturday, June 1, 2024