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. 2008 Nov 24;40(2):69–74. [Article in Spanish] doi: 10.1157/13116152

Determinación ambulatoria de glucohemoglobina en el seguimiento y el control de la diabetes mellitus: revisión sistemática de la literatura

Out-patient determination of glycosylated haemoglobin in the monitoring and control of diabetes mellitus: systematic review of the literature

Jesús Ruiz-Aragón 1,⁎, Román Villegas Portero 1, Sandra Flores Moreno 1
PMCID: PMC7659817  PMID: 18358159

Abstract

Objective

To compare out-patient determination of HbA1c with lab figures, by measuring metabolic control, quality of life and hypoglycaemia episodes, in adults with type-1 or -2 Diabetes mellitus.

Design

Systematic review.

Data sources

MEDLINE (1966-August 2006), EMBASE (2000-August 2006), bases held by the Center for Reviews and Dissemination (DARE, INAHTA, NHSEED), Cochrane Library (number 3, 2006), European Medication Agency, Food and Drug Administration and the European Network of Emerging Technologies. A manual search was made in Point of Care and in the register of trials, ClinicalTrials.gov.

Methods

Inclusion criteria were studies with type-1 or -2 diabetics who used portable out-patient devices and with comparison with lab references. Studies of minors, of any other kind of Diabetes, of patients without a portable device and where the comparator did not include reference methods were excluded. Those that a priori met the criteria were recovered fully. A quality analysis was run according to the CASPe programme criteria and data were extracted with specific formulae. As meta-analysis was not possible, a qualitative synthesis was made.

Results

Twenty publications were selected. The values of most devices correlated well (R2=0.85 and R2=0.059; P<.001). Some studies described increase in glycaemia control, with drop in HbA1c of 0.1-1.5% (P<.01); therapy control was more intense (OR: 0.95-1.52; CI 95%) and visits to the doctor decreased.

Conclusions

Out-patient evaluations are rapid and comfortable, increasing patients’ metabolic control. However, they possess certain limitations.

Key words: Diabetes mellitus, Glycosylated haemoglobin, Diagnosis, Point of care, Health technology assessment

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