A new research study by Kaiser Permanente shows point-of-care A1C testing leads to better care, better outcomes, and fewer complications for patients with uncontrolled diabetes.
Reynaldo Alonso, MD, uses a point-of-care A1C testing machine to quickly check a patient’s blood sugar level.
As the COVID-19 pandemic first surged across the United States in 2020, Reynaldo Alonso, MD, an internal medicine physician at Kaiser Permanente in Southern California, noticed his patients with diabetes were struggling to maintain healthy blood sugar levels. Diabetes is a chronic condition that causes blood glucose, or sugar, levels to rise higher than normal.
When they came into the office for a visit, follow-up lab tests to check their hemoglobin A1C — the average blood sugar level over the past 2 to 3 months — seemed to be lagging.
Over time, diabetes can cause serious health problems and damage vital organs. However, studies have shown that effective blood sugar control can dramatically reduce the risk of eye disease, kidney disease, heart disease, and nerve disease in people with diabetes.
“If we could get the patient’s A1C test done in the office, we could address the need for more medication right there, or counsel the patient on the need for lifestyle changes that could help prevent diabetic complications,” said Dr. Alonso.
Dr. Alonso got approval to buy one point-of-care A1C testing machine, which was about the size of a toaster and required only a drop of blood from a patient’s finger to run a test. It delivered results in just 2 to 3 minutes.
The pilot received positive feedback from both patients and physicians, clearing the way for the program to expand. By 2022, 7 primary care clinics in the Los Angeles area were equipped with at least one machine.
Dr. Alonso, seeing the value of this program, didn’t stop there. He enlisted the help of researchers at Kaiser Permanente Los Angeles Medical Center and the Kaiser Permanente Department of Research & Evaluation to design a formal research study to see if the use of A1C testing machines in primary care offices improved blood sugar control in patients on a broader scale.
The study looked at 10,909 patients with diabetes who had a primary care visit between January 2021 and December 2023. Of those, more than 3,000 patients had at least one visit where the A1C office test was used. The patients who had been tested in the office were matched, based on age and health conditions, with the same number of patients who didn’t get the test. Then researchers compared the level of their diabetes control.
Results showed little difference for patients with controlled diabetes, but for patients with uncontrolled diabetes (A1C of 8% or greater), there was a significant 0.7% reduction in A1C within 3 months.
“What this told us was that it may be best to target patients with a history of higher blood sugar levels than all people with diabetes,” said Dr. Alonso.
The study was published online in the Journal of General Internal Medicine in January 2025.
Since the study findings became available in January, there has been a steady expansion of the program to new locations in Southern California, such as San Diego, and into specialty clinics such as optometry, where a patient might seek care related to conditions resulting from their diabetes.
Dr. Alonso said he believes the work will improve the future health of patients with diabetes.
“It’s been great to be able to work with patients and improve their life by hopefully preventing complications of diabetes,” Dr. Alonso said. “And it’s great to work in an organization like Kaiser Permanente where something like this — something so impactful — can be done.”