Using glycated haemoglobin testing to simplify diabetes screening in remote Aboriginal Australian health care settings

Objectives: To determine whether a combination of point‐of‐care (POC) and laboratory glycated haemoglobin A (HbA1c) testing (HbA1c algorithm) is more effective in testing for diabetes in everyday practice in remote Australian Aboriginal primary health care, by providing a more rapid definitive result and diagnosing more cases than the standard glucose algorithm. Design: Cross‐sectional study that independently classified participants using both diagnostic algorithms and compared their outcomes. Participants: Two hundred and fifty‐five Aboriginal Australians aged 15 years or more without confirmed diabetes and due for diabetes testing at participating clinics. Setting: Six primary health care sites in the Kimberley region of Western Australia from 1 September 2011 to 30 November 2013. Main outcome measures: Number of participants with a definitive test result, a completed algorithm and a diagnosis of diabetes; time taken to deliver a test result. Results: Participants were significantly more likely to have a definitive result within 7 days (249 v 199 of 255 participants; P