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Evaluation of the prevalence of inappropriate hba1c examination requests at the General Hospital of Dokter Saiful Anwar Malang

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Abstract

Background/purpose of the study

The HbA1c test was officially introduced by the American Diabetes Association (ADA) as a diagnostic and monitoring tool for diabetes mellitus in 2010.The following year, the World Health Organization (WHO) decided to accept the use of this test for similar reasons. The HbA1c test reflects average plasma glucose over the proceeding 8 to 12 weeks. Therefore, this test should ideally be performed every 2 to 3 months. The HbA1c value can be inaccurate with certain comorbidities such as hemoglobinopathies, high turnover of erythrocytes, and following blood transfusion. In developing countries, HbA1c tests are quite expensive so its demand must be appropriate. This study aims to evaluate the early HbA1c test, which was performed in less than 3 months, and its association with the incidence of hemoglobinopathies in the Dr. Saiful Anwar Hospital.

Methods

This is a retrospective study using historical data from the Laboratory Information System (LIS) in the period of 2012 until 2017.

Results

Over 5 years, there were 32,000 HbA1c tests. About 18% were repeated more than two times in less than 3 months. Of this number, 6.4% was performed in less than a month, 5.9% in 1 to 2 months, and 5.7% in 2 to 3 months.

Conclusion

This may not only be caused by the lack of communication between clinicians and laboratory personnel, but also the presence of hemoglobinopathies, causing unreliable results. Requesting HbA1c test too early can result in inaccurate measurements. As a consequence, there is a need for better communication between clinicians and laboratory personnel.

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Acknowledgments

We would like to thank the Dean of Medical Faculty of Universitas Brawijaya and Direktorat Jendral of Research, Technology and Higher Education of Indonesia, Saiful Anwar General Hospital of Malang, East Java and our colleagues from Department of Child Health, Faculty of Medicine, Universitas Brawijaya.

Funding

This study is supported by Wynacom Unitama Sejahtera Company and dr. Saiful Anwar General Hospital.

Author information

Authors and Affiliations

  1. Lecturer of Clinical Pathology Department, Faculty of Medicine, Brawijaya University/Saiful Anwar General Hospital, Malang, Indonesia

    Anik Widijanti & Catur Suci Sutrisnani

  2. Resident of Clinical Pathology Department, Faculty of Medicine, Brawijaya University/Saiful Anwar General Hospital, Malang, Indonesia

    Andrea Aprilia & Marianne Lukytha Tangdililing

Authors
  1. Anik Widijanti
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  2. Andrea Aprilia
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  3. Catur Suci Sutrisnani
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  4. Marianne Lukytha Tangdililing
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Contributions

All authors have contributed to this study.

Corresponding author

Correspondence to Andrea Aprilia.

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Ethics approval

The study was conducted according to the Declaration of Helsinki and was approved by the ethics committee of our institution.

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The authors declare no competing interests.

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Widijanti, A., Aprilia, A., Sutrisnani, C.S. et al. Evaluation of the prevalence of inappropriate hba1c examination requests at the General Hospital of Dokter Saiful Anwar Malang. Int J Diabetes Dev Ctries 42, 560–564 (2022). https://doi.org/10.1007/s13410-021-00996-8

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  • DOI: https://doi.org/10.1007/s13410-021-00996-8

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