ABSTRACT
The American Diabetes Association (ADA) estimates that 25.8 million Americans have diabetes, 79 million have prediabetes, and 7 million are undiagnosed.1 These staggering statistics are expected to rise dramatically. The total cost of diabetes care in the United States in 2007 was 218 billion dollars.1 Globally, the disease has reached epidemic proportions, with 171 million people worldwide, and projected to increase to 366 million people by 2030.2 Earlier identification and treatment of prediabetes as well as diabetes are critical to decrease future morbidity and associated health care costs.In 2010, the ADA updated their clinical recommendation criteria for diagnosing diabetes and prediabetes to include the use of the laboratory test HbA1c.3 Following that, the ADA noted that the limitations of the HbA1c do not outweigh its benefits for diagnosing diabetes and preventing diabetes-related complications. In 2011, the ADA's "Standards of Medical Care" recommended using point-of-care (POC) HbA1c testing to make timely decisions on therapy changes.4 A joint position statement from the American Association of Clinical Endocrinologists and the American College of Endocrinology acknowledged the advantage of the HbA1c test, but they are not in agreement with the ADA recommendation to use the HbA1c as a sole criterion for diagnosing diabetes.5 They suggested that the HbA1c should be used in conjunction with other criteria when diagnosing diabetes, but not used as a stand-alone diagnostic measure as recommended by the ADA.The HbA1c test provides a golden opportunity to identify and begin treating the considerable number of people undiagnosed with diabetes.6 Research studies demonstrate that using the current technology of the rapid POC HbA1c can be instrumental in early identification of diabetes, disease management, and prevention of costly complications (Table 1). The POC HbA1c is a simple finger stick and can produce reliable results in minutes.10 Point-of-care HbA1c should
