Evidence map›Paper›PMID 40165254›Full record

Trial reportBMC medicine2025

Improving type 2 diabetes detection among at-risk individuals - comparing the effectiveness of active opportunistic screening using spot capillary-HbA1c testing and venous HbA1c testing: a cluster randomized controlled trial.

Linda Chan, Esther Yee Tak Yu, Eric Yuk Fai Wan, Samuel Yeung Shan Wong, David Vai Kiong Chao, Welchie Wai Kit Ko, Catherine Xiao Rui Chen, Paul Po Ling Chan, Emma Victoria Marianne Bilney, Eng Sing Lee and 2 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06382363 (Improving T2DM Detection Among At-Risk Individuals - Effectiveness of Active Opportunistic Screening Using Spot Capillary-HbA1c Test - a Cluster Randomized Controlled Trial), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06382363 nacompletednot on this map

Improving T2DM Detection Among At-Risk Individuals - Effectiveness of Active Opportunistic Screening Using Spot Capillary-HbA1c Test - a Cluster Randomized Controlled Trial (DM-REACH)

TypeinterventionalSponsorThe University of Hong KongRan2022 to 2023Enrolled852ConditionsDiabetes Mellitus, Pre-diabetesArmsPOC-cHbA1c testing
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Linda Chan *Department of Family Medicine and Primary Care, Ap Lei Chau Clinic, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau, Hong Kong SAR, China. lmjchan@hku.hk.
Esther Yee Tak Yu *Health Bureau, Primary Healthcare Commission, Hong Kong SAR, China.
Eric Yuk Fai WanDepartment of Family Medicine and Primary Care, Ap Lei Chau Clinic, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau, Hong Kong SAR, China.
Samuel Yeung Shan WongThe Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
David Vai Kiong ChaoDepartment of Family Medicine and Primary Health Care, United Christian Hospital, Kowloon East Cluster, Hong Kong Hospital Authority, Hong Kong SAR, China.
Welchie Wai Kit KoHong Kong Hospital Authority, Hong Kong SAR, China.
Catherine Xiao Rui ChenHong Kong Hospital Authority, Hong Kong SAR, China.
Paul Po Ling ChanDepartment of Family Medicine and Primary Care, Ap Lei Chau Clinic, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau, Hong Kong SAR, China.
Emma Victoria Marianne BilneyDepartment of Family Medicine and Primary Care, Ap Lei Chau Clinic, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau, Hong Kong SAR, China.
Eng Sing LeeLee Kong Chian School of Medicine, Nanyang Technology University, Singapore, Singapore.
Wei Leik NgDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Cindy Lo Kuen LamDepartment of Family Medicine and Primary Care, Ap Lei Chau Clinic, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau, Hong Kong SAR, China.

Funding

Health and Medical Research Fund 18191751
6 · The paper itself

Abstract

backgroundDelayed diagnosis and treatment of type 2 diabetes increases diabetes-related complications, making the high prevalence of undiagnosed type 2 diabetes in Hong Kong an important concern. Point-of-care capillary HbA1c (POC-cHbA1c) testing holds promise as a comparably accurate, convenient, and timely alternative to venous HbA1c (vHbA1c) for type 2 diabetes screening, yet randomized trials are lacking. This study compared the effectiveness of a 2-step active opportunistic screening strategy using POC-cHbA1c versus usual practice employing vHbA1c and multiple clinic visits in detecting type 2 diabetes among at-risk primary care patients. The primary outcomes were to identify the difference in the proportion of type 2 diabetes detected between intervention (POC-cHbA1c) and control (vHbA1c) groups and the uptake rate of POC-cHbA1c versus vHbA1c testing among consenting participants.

methodsA cluster randomized controlled trial was conducted in 8 General Out-Patient Clinics between June 2022 and January 2024 using 2-step active opportunistic screening. In step 1, risk factor count, 852 at-risk patients were identified through consecutive sampling during their primary care consultation by specific inclusion and exclusion criteria. In step 2, these at-risk patients then underwent POC-cHbA1c (intervention) or vHbA1c (control) testing. If preliminary HbA1c was ≥ 5.6%, a confirmatory oral glucose tolerance test was offered. Randomization occurred at the clinic level using a random allocation sequence generated by statistical software. Multilevel logistic regression analyses were employed to evaluate the effect of the intervention on the uptake rate, adjusting for patient characteristics and clinic clustering.

resultsPOC-cHbA1c had a higher uptake rate than vHbA1c (76.0% vs 37.5%; OR = 7.06, 95% CI [2.47-20.18], p < 0.001). A greater proportion of type 2 diabetes (4.2% vs 1.4%; p = 0.016) and pre-diabetes (11.8% vs 6.9%; p = 0.015) were detected using POC-cHbA1c versus vHbA1c. POC-cHbA1c was more likely to detect type 2 diabetes/pre-diabetes combined (OR = 1.99, 95% CI [1.01-3.95], p = 0.048). The number-needed-to-screen to detect one additional type 2 diabetes patient with POC-cHbA1c was 61 versus vHbA1c.

conclusionsPOC-cHbA1c testing was associated with a higher uptake rate and detection of type 2 diabetes versus vHbA1c, underscoring its potential as an effective type 2 diabetes screening strategy in primary care.

trial registrationNCT06382363 (retrospectively registered: 2024-04-19).

Indexed as

Diabetes Mellitus, Type 2Glycated HemoglobinMass ScreeningPoint-of-Care TestingAdultAgedFemaleHong KongHumansMaleMiddle AgedRisk FactorsGlycated Hemoglobinhemoglobin A1c protein, humanPOC-cHbA1cPoint-of-care capillary HbA1cPrimary careScreeningType 2 diabetes

Identifiers

PMID40165254
PMCPMC11959842

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.