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Those of us living with diabetes are encouraged to get our blood drawn every 3 months or so, either at a clinician’s office or a medical lab, to get our all-important A1C test, that indicates how we’re doing with blood sugar control.

Either way, there’s travel time and waiting involved to get our A1C result.

But there is another way: The real-time home A1C test is making a comeback, now available at your local drugstore. With just a fingerprick and a 5-minute wait, you can get that result right in the comfort of your own home with no need to go anywhere or even send your blood work off by mail.

While not all agree these at-home kits are as accurate as clinician or lab work results, they can be an accessible, affordable and easy way to get more insight into one’s diabetes management. This might be especially important while we’re still navigating the COVID-19 pandemic, when people may not be as comfortable with in-person appointments, or if the cost of a clinician or lab visit is prohibitive.

Your A1C, or HbA1c as it’s sometimes referred to (because of its proper name: hemoglobin A1C), provides an average of your blood glucose readings over the past 3 months. First introduced in the 1980s, it officially became a standard of care following the landmark Diabetes Care and Complications Trial (DCCT) in 1993.

For the past few decades, A1C has been dubbed the “gold standard” of diabetes management; clinicians and people with diabetes (PWDs) regularly look to this result as a gauge to how well a person is managing their diabetes.

The American Diabetes Association states that the goal for most adults with diabetes is an A1C result of less than 7 percent.

Many PWDs end up viewing the A1C as a sort of report card letting us know whether we’re doing “good” or “bad,” which is unfortunate because this can create a lot of guilt.

The real issue with the A1C is that it only provides an average of glucose levels over the prior 12 weeks, but doesn’t reflect change or variability. So, two people with an A1C of 6.7 percent could have very different management profiles, where one has very steady glucose levels, but the other person has highly variable levels with frequent hypoglycemia. Or someone could have an “ideal” A1C level of 6 percent, but it only reflects a middle point between 3 months of severe high and low blood sugars.

That’s why there is increasing attention around a measure called Time in Range (TIR), that uses continuous glucose monitor (CGM) results to show the amount of time a PWD stays within the desired glucose range, over any period of days, weeks, or months.

All of that being said, the A1C is still an important measure that is used in diabetes care across the country. So, having the option to use an affordable, easy at-home testing kit is a big win.

I bought an A1C Test Kit at my local Walgreens. It included two tests, though there were other kits with four tests at a higher price-point.

Importantly, this is the same product as the “A1C Now Self Check” kit originally made by Bayer before being sold to PTS Diagnostics in 2019. It’s now licensed by pharmacies like Walgreens, which put their company brand name on it.

So, while some may refer to this handheld device as the “Walgreens A1C” or “CVS A1C” kits, they are the same basic product sold under those different names.

Here’s how you use the kit:

  • In one foil pouch, you’ll find a plastic tube (the shaker), a clear plastic blood collector, and a rectangular lancet to poke your finger.
  • In another pouch, you’ll find the cartridge, which you slide into the bottom of the device to apply the blood and analyze the result. Importantly, the cartridge shouldn’t be removed from the pack more than 2 minutes before you’re going to use it, or that could compromise the test result.
  • Poke your finger with the rectangular lancet and then suck up the blood using the tip of the clear plastic collector. You’ll see it fill up the entire line to show that it’s complete.
  • Insert the blood sample collector into the shaker body tube, with the white base still attached to the bottom. You push hard to insert it, and then shake the tube for 5 seconds to mix the blood and test solution inside.
  • After all that, you open the second foil pouch with the cartridge. Insert that into the bottom of the analyzer, matching up the code on both the meter and cartridge.
  • Wait for the meter to display “SAMPLE” and show a flashing blood drop icon, meaning it’s ready for the sample, and then remove the base and insert the shaker tube into the circle on the cartridge.
  • Push the tube down and then remove it quickly. The meter will say “RUN” and it counts down 5 minutes to generate an A1C result.
  • Assuming all’s good, it will display a “QCOK” code, which means your A1C result passed the quality check.

This probably sounds a lot more complicated than it is. Watch this helpful instructional video by the manufacturer for a visual step-by-step guide on using these at-home A1C kits. I actually found this particularly helpful, because the Walgreens A1C Test Kit I bought at my local store didn’t have any instructions inside and there’s nothing shown on the box — so I needed to turn to the internet for help using it.

While research on these over-the-counter A1C tests is scarce, this 2010 study showed that of 177 people using the kit, more than 93 percent saw their A1C results come back at a range within 13.5 percent of the lab value. A majority said they felt confident in the accuracy and were likely to discuss the results with their healthcare professionals.

The manufacturer PTS Diagnostics states that results may differ by as much as 1.0 percent to .8 percent from the true lab result — meaning it represents a 95 percent confidence limit on the “Bland-Altman plot,” a standard assessment used for comparing medical results.

Personally, the two A1C results that I got from my Walgreens-bought kit were a bit higher than my lab work results:

  • First test on same day as lab visit: 7.7 percent
  • Second test a few days later: 8.0 percent
  • Both were higher than my lab-collected A1C result: 7.5 percent

Still, I take the results as a good glimpse of where my blood sugars and diabetes management have been over the past several weeks. This is informative enough for me and my doctor to make use of.

You can find these at-home A1C tests at pretty much any pharmacy across the United States, particularly the larger ones like Walgreens, CVS, Rite Aid, Target, and Walmart. As mentioned earlier, they have different labeling and company names attached and some offer a two-test kit while others have four or six cartridges for more A1C results.

These range in price from $44 to over $100, depending on which amount you’re buying at the store.

You can also find these home A1C kits on Amazon.

Note that these at-home A1C kits are not covered by insurance, as they typically do not meet the criteria that insurers require for a professional A1C result.

Another option to get your A1C result without going directly to a doctor’s office or clinical lab are mail-in tests, which are similar to the at-home kits but require you to send off the blood you collect for analysis.

These are affordable too, ranging from $30 to $90, and some also offer monthly or yearly subscription services that include more than one or two A1C tests. But getting the results takes anywhere from weeks to days to 24 hours at the shortest.

On that level, it’s hard to compete with the 5-minute results provided by these newer kits made by PTS Diagnostics.

Even though it’s not collected in person by a physician or in a lab, I’d still recommend a these Home A1C Kits. They’re easy to use, you get an immediate result with decent accuracy, and they do away with the barriers for many people in getting an A1C test done regularly.

In short, this affordable tool can be beneficial for anyone facing cost barriers, or who is unable or unwilling to wait for an in-person appointment, as well as those who might want a more frequent A1C to gauge their progress — such as pregnant PWDs striving for tighter management.