The dried blood spot (DBS) card is a novel collection method for measuring glycated hemoglobin (A1C) in individuals with diabetes mellitus. The potential benefits of DBS specimens compared with traditional phlebotomy include a reduction in required total blood volume, reduced procedural pain, and an ability for self-initiated collection. DBS cards for A1C measurement have been validated in the adult population, but there is a paucity of pediatric data. The aim of this study was to validate the use of A1C measurement by DBS cards in comparison to venous A1C and to identify potential barriers to implementing this novel approach. Venous and DBS card A1C samples were collected simultaneously from 62 patients at their local laboratory and transported to the central provincial lab for analysis. Correlation analyses compared venous and DBS A1C with data rescaling performed to account for the DBS–venous interassay difference. Mean venous A1C was 7.49% and DBS A1C was 7.26%, with an interassay difference of 0.23%. Data showed a strong, positive correlation between A1C collection methods (r=0.86, p<0.001); this was further strengthened at lower A1C values (A1C <7.5%, r=0.87, p<0.0001). A stronger relationship emerged when the data were rescaled to account for the DBS–venous interassay difference (r=0.8935, p<0.0001). Given the potential feasibility, practicality, accessibility, cost-effectiveness, and performance characteristics of the DBS A1C, especially at lower A1C values hovering around the diagnostic threshold for diabetes, this study provides supporting evidence for consideration of the use of DBS A1C testing in pediatric diabetes care.

中文翻译：

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干血斑试验用于测量小儿糖尿病护理中的糖化血红蛋白

干血斑 (DBS) 卡是一种用于测量糖尿病患者糖化血红蛋白 (A1C) 的新型采集方法。与传统放血术相比，DBS 标本的潜在好处包括减少所需的总血量、减少手术疼痛以及能够自行采集。用于 A1C 测量的 DBS 卡已在成年人中得到验证，但儿科数据很少。本研究的目的是验证 DBS 卡 A1C 测量与静脉 A1C 测量的比较，并确定实施这种新方法的潜在障碍。在当地实验室同时采集 62 名患者的静脉和 DBS 卡 A1C 样本，并运至中央省实验室进行分析。相关分析比较了静脉 A1C 和 DBS A1C，并进行数据重新调整以解释 DBS-静脉测定间的差异。平均静脉 A1C 为 7.49%，DBS A1C 为 7.26%，批间差异为 0.23%。数据显示 A1C 收集方法之间存在很强的正相关性（r=0.86，p<0.001）；这种现象在较低的 A1C 值下进一步加强（A1C <7.5%，r=0.87，p<0.0001）。当重新调整数据以解释 DBS-静脉分析间差异时，出现了更强的关系（r=0.8935，p<0.0001）。鉴于 DBS A1C 的潜在可行性、实用性、可及性、成本效益和性能特征，特别是在糖尿病诊断阈值附近徘徊的较低 A1C 值时，本研究为考虑在儿科中使用 DBS A1C 测试提供了支持证据糖尿病护理。