a1c and blood sugars

A Better A1C Test

David Mendosa Health Guide November 09, 2008
  • Even in these difficult times when almost all of us are learning how to become frugal again, money isn't everything. Especially when it comes to our health.

    For those of us who have diabetes the A1C test is the best measure that we have of the state of our health. The A1C is the only commonly available check that we have of our average blood glucose level for the past two or three months.

    Those of us who are fortunate enough to have health insurance usually go to the lab at our doctor's office or local hospital for their A1C. I know that's what I was doing several times a year ever since my diabetes diagnosis in 1994. My health insurance provides up to two A1C tests annually for a modest $15 co-pay each time for my visit to my primary care physician.


    But until now I didn't take into account how much time getting an A1C test at the lab took out of my busy schedule. And most importantly, I didn't realize that the lab's results may not be right.

    Now, for a few dollars more than even people who have health insurance have to pay for an A1C test we have a much better alternative. It's the Appraise Diabetes A1c Test from Heritage Labs in Olathe, Kansas.

     

    Ordering an Appraise test kit from the Heritage Labs website takes only a couple of minutes. Or if you are at one of the stores that carry it, including Wal-Mart under the Reli-On A1c Test brand name and at Rite-Aid drugstores under the Appraise brand name, you can pick it up while you're there. So the next time I want to check my A1C I won't have to make an appointment for a lab test, then drive there and back, and later make an appointment with my doctor to get the results, and drive there and back.


    The testing procedure is simple and clear. Unlike some home A1C tests that I used before, I felt confident that I hadn't introduced any user error. The Appraise test uses a small drop of blood from a fingerprick, unlike the large vial that my hospital drew from my arm.


    We can get our Appraise test result online via a secure website or through the mail. Heritage Labs says that processing can take as few as three days. In my experience with my first Appraise test, I dropped it in my mailbox on Thursday, October 16. Heritage Labs received it after the weekend on October 21 and reported the results to me that day.

    I know that many of us are a little dubious about the reliability of home A1C test kits like the Appraise that use dried blood spots. I know that I was.

    But the Appraise test is more reliable that my hospital's test or that of just about any hospital.
    The National Glycohemoglobin Standardization Program certified the Appraise laboratory as having documented traceability to the Diabetes Control and Complications Trial reference method, which established relationships between A1C levels and risk for complications of diabetes. The DCCT method is the gold standard for reliable A1C testing. For more information, please see the 1999 article I wrote for the American Diabetes Association.


    The NGSP has certified 78 laboratories worldwide, and only 20 of those labs are in the U.S. The Appraise test is the only laboratory worldwide specifically listed to be certified for A1C testing using dried blood spot specimens.The complete list is online, and my hospital isn't one of them. I can identify only one hospital, the Mayo Clinic, among the 20 certified American labs.


  • According to the Appraise test that I took on October 16, my A1C was 5.2 percent. The hospital test that I took less than three weeks later on November 4 was 5.5 percent. Since my diet, weight, and exercise remained the same, I expected closer results, although they may be within the margin of error. Considering that the NGSP certified the Appraise test and not the hospital one, I know which one is more likely to be right.


    Finally, we have the little matter of price. The hospital test cost me a $15 co-pay and several hours of my time. The Appraise test sells for $19.95, and we don't need a prescription to buy one. Heritage Labs gave me the first test kit. But I just ordered another one so I can check my A1C again in a couple of months on my nickel.