HbA1c by mail

You may find it cheaper and/or more convenient to have your HbA1c
measurements done by mail -- and you collect the sample by fingerstick.

Diabetes Technologies provides a "Accu-Base A1c (tm) Glycohemoglobin
Testing System". The cost is $19.95 per kit plus S/H (I think it's $3.85
per order), which includes the laboratory analysis. All needed supplies
are provided, including postage to the lab. They normally ask for a
doctor's prescription before sending the kit -- not because it's
required but because they want to make sure to keep the doctors in the
loop. Unhappy doctors are not good for their business.

The procedure is simple: they provide a capillary tube already attached
to a clip. Stick your finger (using a one-use lancet they provide, if
you wish) and touch the end of the tube to the drop until the tube is
full -- a fraction of a second to a few seconds. Drop the tube into a
small vial with fluid in it (pre-filled) and shake for a few seconds.
Fill out a little paperwork. Pack the vial in a Biopack, padding and
package, all provided and even prestamped. Drop it in the mail. You
provide: writing pen, blood, tissue for the excess blood.

The lab analyzes the sample using HPLC (high performance liquid
chromotography). This is the same as the major labs use. In other words,
SmithKline takes an entire vial of blood and uses one drop.

Diabetes Technologies is in Thomasville, GA. Their phone number is
888-872-2443.

Express-Med used to make a kit which I used once, but they no longer
sell it.

Becton-Dickinson (BD) was advertising a HbA1c kit in 1998. However, the
last time I spoke with someone there, they were only distributing it
through health care organizations (such as HMOs) and plans for
individual sales were indefinite.

A personal note: I have used the Diabetes Technologies kit, and a
predecessor supplied by Diabetes Support Systems, since 1996. Without
this service, I probably would have had at most one HbA1c measurement
per year due to the cost and the inconvenience of visiting the lab or
doctor's office -- and I really needed the tests at times. I plan to
continue using the service.

(As of the start of 2003 there are some other options. I need to update
this section.)