HbA1c monitoring

Good blood glucose control is essential for effective management of diabetes, with high blood glucose increasing the risk and associated costs of complications. Glycaemic control in diabetes is monitored by regular testing of HbA1c. In NHS Highland patients requiring HbA1c tests attend their GP practice for venepuncture, with blood samples sent to Raigmore Hospital for analysis. This project aims to provide a more convenient and acceptable method of blood sample collection especially for rural dwellers: dried blood spots prepared by the patient at home using capillary blood. The project builds on a pilot study which demonstrated a strong correlation between venous and capillary dried blood spot HbA1c levels.

Remote HbA1c monitoring (RHAM)

The study is being conducted in two phases:

Phase 1: Semi-structured interviews to the point of saturation with a cohort of patients attending urban (Inverness) and peripheral (Skye) diabetes clinics to ascertain views on the dried blood spot and HbA1c self-testing approach in diabetes management. This will both help inform phase 2 content and augment opinions of service users on the wider question of compliance with long term monitoring of diabetes. The protocol for Phase 2 will reflect these views.

Phase 2: Participants attending routine clinics in Inverness will be recruited and asked to prepare dried blood spots at home and return these by post to Raigmore Hospital in Inverness for analysis. Results will be compared with HbA1c levels in venous samples taken at the routine clinics. A questionnaire will assess participants' views on ease of use and acceptability after completion and return of dried blood samples.

Project Team

  • Professor Sandra MacRury, Professor of Clinical Diabetes
  • Dr Jenny Hall, Research Fellow, Rural Health and Wellbeing
  • Funders: Chief Scientist Office
  • Partners: NHS Highland - Dr Marie Van Drimmelen, Consultant Chemical Pathologist