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Background: The objective of this study was to assess the feasibility of using blood spots collected by finger sticks and dried on filter paper for measuring Hemoglobin A1c (HbA1c) by a new method to assess long term glycemic control. Blood spots offer advantages of short collection time, low invasiveness, reduction of sample volume, ability to obtain repeated measures and ease of sample storage. Methods: Forty subjects contributed a blood spot sample from a finger stick and a blood sample through venipuncture. The blood spots obtained from finger sticks on a filter paper were air-dried for 4 hours at room temperature after collection. Using an automated dried blood spot (DBS) puncher, 6.0 mm blood disks were obtained for testing and rehydrated in assay buffer. All samples were tested in parallel. Samples were evaluated for the presence of HbA1C using conventional commercial kits based on an immuno-turbidimetric assay in whole blood modified for use in dried blood spots. Results: A positive correlation (R²= 0.93) was found in HbA1c levels from the blood spot and whole blood samples. The HbA1c levels obtained from blood spots (5.41 ± 1.06%; Assay range 3.36%- 12.02%) were similar to those derived from whole blood samples (5.44 ± 1.68%; Assay range 4.92%-12.29%). The extracted samples showed good stability for 8 days when stored at 4°C. The between assay CV ranged between 5.25%- 14.79% and the within run variation was between 4.28%- 10.33%. Conclusion: We conclude that in our assay, HbA1c levels obtained from blood spot samples correlate well with values obtained from standard whole blood assays. The design of the assay and nature of the samples also make this method suitable for screening programs that consist of self-sampling for better management of chronic glycemia and its complications. [ABSTRACT FROM AUTHOR]

Background: Individuals with conditions of inflammation, insulin resistance and obesity are at higher risk of developing cardiovascular and metabolic disorders. Components of cardio-metabolic and metabolic syndrome have been reported to correlate with increased levels of insulin and inflammatory markers like C-reactive protein. Evaluation of fasting blood insulin, C-reactive protein and triglycerides in dried blood spot may help patients and their physicians plan an intervention program against related risk factors. Patients and Methods: Fifty individuals with ages ranging from 10 to 68 years responded to an advertisement asking for volunteers for a study to evaluate the metabolic syndrome wellness program. Only overweight individuals were asked to reply. After giving informed consent and having the protocol of the study explained, volunteers submitted a finger stick blood sample that was tested for fasting blood insulin, high sensitivity C-reactive protein (hs-CRP) and triglycerides. The premise of the study was to use the fasting blood insulin as a measure of an individual's insulin resistance. Results: Nineteen individuals with clinical manifestations of metabolic syndrome had fasting blood insulin levels less than 8 and were considered to have normal insulin resistance. The majority of these individuals had significant weight loss of 10 to 20 pounds before entering the wellness program. Significant findings from this study were elevations of the hs-CRP. This was also true for the individuals who had apparently regained normal insulin sensitivity by exercise and weight loss. A relationship was also noted between lower hs CRP and eating four helpings of fresh fruits and vegetables daily. Conclusions: One might hypothesize that glycated proteins from previously elevated insulin levels resulted in a continuing inflammation or immune problem. If possible we will try to determine if glyconutrients might tend to normalize the hs-C-reactive protein. The next phase of this study will be to correlate the volunteers' new information about the factors causing insulin resistance and their ability to change nutrition and lifestyle to reverse the increased health risks of metabolic syndrome. [ABSTRACT FROM AUTHOR]