1. HumaMeter A1c

2. HumaMeter A1c Product Overview HbA1c and Diabetes Performing a Test
Basic Maintenance
Summary
HumaMeter A1c

3. Product Overview HumaMeter A1c is a revolution in HbA1c measurement:
It combines market-leading PoC analyser accuracy with low cost, easy to use technology.
HumaMeter A1c

4. HumaMeter A1c Analyser Door with automatic switch
Large backlit display
Reagent cartridge
Barcode scanner
HumaMeter A1c

5. Product Features Data Easy to use Practical Fast and accurate
Step by step instructions on display
Multi-lingual menu
Innovative blood collector allows easy sampling
Practical
Compact size
Weight: 0.7kg
Self-testing
Small sample size (4 μl)
Fast and accurate
Results in 4 minutes
Imprecision: CV <3% at 7% A1c
Data
Stores up to 7,000 records
Barcode identification
USB port for PC
Barcode reader for calibration data, patient and operator ID
Accessories
Optional label printer
HumaMeter A1c

6. Technical Information
Boronate Affinity methodology (interference free)
Traceable to the IFCC reference method
Imprecision: CV <3% (at 7% A1c)
Measuring range: % A1c ( mmol/mol)
Unaffected by Hb variants (which do not result in reduced erythrocyte life span)
User selectable dual reporting. Choose from % DCCT, IFCC mmol/mol, % JDS, eAG mg/dL or eAG mmol/L
Optional printer
HumaMeter A1c

7. HumaMeter A1c Reagent Test Cartridges
Small sample size required (4 μL)
Fast measuring time (approx. 4 minutes)
Reagent stability of 12 months at 2-8 °C; thereof up to 90 room temp. (uncooled)*
Sold in compact boxes of 50 (2 * 25) reagent cartridges with 50+ sample sticks; imprinted calibration barcode
*18 – 25°C
HumaMeter A1c

8. Components and Accessories
Ordering information:
Product
Included
Ref. No.
HumaMeter A1c analyzer
Analyzer, User Manual (GB, F, E, RUS), Barcode scanner, Power supply
16080
HumaMeter HbA1c reagent kit
50 test cartridges, 50 sample sticks, 1 IFU, calibration barcode
16085/50
HumaMeter HbA1c control
16086
Optional accessories:
Product
Ref. No.
Printer HumaMeter A1c
16081
Printer label rolls HumaMeter A1c (320 labels)
16082
Spare parts:
There are no serviceable parts. If broken or lost, the following parts can be exchanged by the user:
Barcode scanner HumaMeter A1c (Ref. No )
Printer cable HumaMeter A1c (Ref. No /1)
HumaMeter A1c

9. HbA1c and Diabetes

10. HbA1c and Diabetes Diabetes mellitus (commonly : ”Diabetes”):
Diseases in which a person has high blood sugar (=Glucose)
Reasons: Body produces not enough insulin or cells do not respond to the insulin produced.
2 Types:
Type 1 diabetes (Insulin-dependent diabetes): Caused by loss of insulin-producing beta cells in pancreas. Usually young people.
Type 2 diabetes (Non-insulin dependent diabetes): Results from insulin resistance (cells fail to use insulin properly). Sometimes combined with insulin deficiency. Typically in adults over 40 and overweight patients.
HumaMeter A1c

11. HbA1c and Diabetes Causes of Diabetes High Blood Pressure
High blood triglyceride (fat) levels
Poor diet (processed simple carbs and sugars)
Sedentary lifestyle
Obesity or being overweight
Increasing age
Pregnancy (gestational diabetes)
Pancreatitis
HumaMeter A1c

12. Tingling or numbness in the hand and feet Extreme unexplained fatigue
HbA1c and Diabetes
Signs and Symptoms of Diabetes
Excessive thirst
Frequent urination
Blurry vision
Sedentary lifestyle
Tingling or numbness in the hand and feet
Wounds that don’t heal
Extreme unexplained fatigue
HumaMeter A1c

13. HbA1c and Diabetes Blood Glucose level is used for
Diabetes: High blood sugar (=Glucose)
Blood Glucose level
is used for
DIABETES Diagnosis & DIABETES Monitoring
HumaMeter A1c

14. HbA1c and Diabetes Functions of Blood:
Transport → …of oxygen, nutrients, electrolytes, hormones and enzymes throughout the body
Regulation → … of fluid and electrolyte balance, temperature
Protection → …against bacteria, viruses, toxins
Wound healing → …through clotting mechanism
HumaMeter A1c

15. HbA1c and Diabetes Components of Blood
Red Blood Cells (RBC) or Erythrocytes – ~99% of blood cells RBC contain hemoglobin, an oxygen-carrying protein. Oxygen binds to hemoglobin in lungs and is the transported to the tissues.
White blood cells (WBC) or Leukocytes Initiate immune responses, < 1% of blood cells.
Platelets (PLT) or Thrombocytes Crucial for blood clotting & wound healing.
Plasma Yellow fluid that carries all blood cells; makes up ~55% of blood.
HumaMeter A1c

16. HbA1c and Diabetes Hemoglobin and Glucose
Glucose rapidly diffuses into RBC by facilitated diffusion.
N terminal valine of hemoglobin alpha chain is available for irreversible glycation: Hemoglobin Hb → HbA1c
Hb glycation level (= HbA1c level) is proportional to glucose concentration in plasma !
HumaMeter A1c

17. HbA1c and Diabetes WHY HbA1c?
RBC lifespan: 8-12 weeks → HbA1c concentration indicates average blood glucose level over previous 8-12 weeks
HbA1c testing - one of the best ways to ensure good diabetes control as it reports an overall level, not a snap-shot concentration
HbA1c is not the same as a glucose measurement!
Note: A patient’s HbA1c level is affected e.g. by RBC lifespan, which may be decreased in some conditions.
HumaMeter A1c

18. Summary HbA1c principle - RBC Red blood cells, Hemoglobin & Glucose
RBC: Uptake, transport and release of oxygen
Oxygen bound to Hemoglobin Hb
Glucose easily moves between blood & RBC
Irreversible Glycation (=binding of Glucose) of Hb
Glycated Hb - HbA1c Level of Glycation ~ Glucose in plasma
RBC lifespan = 8-12 weeks: HbA1c concentration indicates average blood glucose levels last 8-12 weeks
HbA1c reports an “overall glucose concentration”, not only a “snap-shot concentration”! HbA1c testing - the best way to ensure good diabetes Discovery & Control!

19. HbA1c and Diabetes HbA1c LEVELS Normal: < 5.7%
Commonly used clinical ranges for glycated hemoglobin (HbA1c) are:
Normal: < 5.7%
Pre-diabetes: 5.7% - 6.4%
Diabetic: 6.5% or higher
Targets should be set for each individual, taking into consideration their risk of severe hyperglycaemia, cardiovascular status and co-morbidities.
Note: The American Diabetes Association recommends a goal of less than 7% DCCT (53 mmol/mol IFCC) for effective management of diabetes and to minimize long-term diabetic complications.
HumaMeter A1c

20. Performing a Test

21. Performing a Test A Few Easy Steps … plus fool-proof display-guidance
Scan lot calibration, remove cartridge foil and insert into analyser.
Press reagent bead into the cartridge.
Take blood sample.
Insert into cartridge and snap the stick.
Close lid.
Results in 4 minutes.
HumaMeter A1c

22. Performing a Test Set Up
Make sure a tray of cartridges & the analyser are equilibrated to working temperature (room temperature)
Scan lot calibration barcode
Remove foil lid from cartridge
Place cartridge into analyser
When prompted, press reagent bead into the cartridge with blunt end of the sample stick
HumaMeter A1c

23. Performing a Test Preparing to Take a Blood Sample
Make sure your patient sits comfortably.
There should be good blood circulation in the hand from which the sample is to be taken.
The hand should be warm and relaxed. If in doubt, warm the hand in lukewarm water.
HumaMeter A1c

24. Performing a Test Stimulating Blood Circulation
Lightly massage the fingers in order to stimulate the circulation.
Operator should wear protective gloves.
Middle or ring finger should be used for taking a sample. Patient should not wear a ring on the finger used for sampling.
Disinfect the puncture site and allow it to dry completely.
HumaMeter A1c

25. Performing a Test Lancing the Finger
Lance the finger on the side of the fingertip. This is less painful and the blood flow is better.
Press lightly on the fingertip and puncture it with a lancet.
A lancet that will create a blood flow of μl is recommended.
Blot away the first drop of blood.
If necessary, press the finger gently again to get a second drop of blood which is large enough to fill the capillary .
Avoid ‘milking’ the finger for blood.
HumaMeter A1c

26. Performing a Test Filling the Sample Stick
Hold the sample stick with the blood collector and lightly touch the pointed tip on the surface of the blood droplet.
Hold the stick in this position until it is filled completely with blood.
Check that the blood collector cavity is completely filled and is free of air bubbles.
Do not top-up the blood collector if it does not completely fill with blood. Instead, repeat the process with a fresh blood sample and stick.
HumaMeter A1c

27. Performing a Test Calibration
Lot calibration is performed by scanning in the bar-code label found on of each cartridge box
Lot calibration can be done:
When the analyser is idle
When the analyser requests it = When “Scan Lot Barcode” appears on the screen
HumaMeter A1c

28. Performing a Test Calibration (Cont.)
Each reagent lot is directly calibrated to IFCC standards received from the European Reference Laboratory.
Cartridge lot calibration is entered into the instrument by scanning the bar code on the box of reagents.
Once the test is finished the results will be expressed in:
% HbA1c/total Hb traceable to DCCT
mmol/mol traceable to the IFCC standard
Reporting methods JDS, Mono-S and eAG also can be selected from set-up menu
HumaMeter A1c

29. Performing a Test Measuring Procedure
Insert the blood collector end of the sample stick into the cartridge that is in the analyser.
Snap off the sample stick handle.
Close the lid of the analyser.
The result will appear on the screen within ~4 minutes.
HumaMeter A1c

30. Basic Maintenance

31. Basic Maintenance Cleaning Procedure
Clean the analyser with a non-abrasive lint free cloth.
Use a mild detergent or commercially available disinfectant if necessary.
Always turn off the analyser by unplugging the power supply before performing any cleaning operation.
HumaMeter A1c

32. Basic Maintenance Storage
Turn off the analyser on a weekly basis for a minimum of 10 seconds so that when it is turned back on again, it will perform the internal self-checks.
If the instrument is stored when not in use, ensure that the mains cord is not liable to damage or kinking.
The analyser is calibrated by the manufacturer and there are no user-serviceable parts.
Reagent shelf-life of up to 90 days (un-refrigerated). Total Reagent stability of 12 months at 2-8 °C.
HumaMeter A1c

33. Competition

34. Hemocue 501 (OEM of Clover)
Competitor analysis I
Axis Shield Nycocard
Infopia Clover
Hemocue 501 (OEM of Clover)
Boditech i-CHROMA
Ceragem Labona Check™
Ceragem Cera-Stat 2000
Bio-Rad IN2IT
HumaMeter A1c
CERTIFICATION
NGSP and IFCC certification
NGSP certified Barcode calibration
NGSP certified
METHODOLOGY
Boronate Affinity
Boronate Affinity reflectance
Immunological
Boronate Affinity with optical reflectance
Fluorescence Quenching
Inverse Amperometry
Chromato-graphy
TIME TO RESULT
<4 mins
3 mins
5 mins
>12 mins
10 mins
MEASUREMENT RANGE % A1C
4 - 15%
4 - 14%
HbA1c: 4 % - 15 %, Hemoglobin: g/dL
SAMPLE VOLUME
4 µl
5 µl
5 ul
10 ul
IMPRECISION, CV AT 7% A1C
<3%
8.5%
<5% %
No info
<4%
SPECIMEN TYPE
Capillary & venous
Finger & venous
Capillary
AFFECTED BY HB VARIANTS* No
Yes
REAGENT TYPE
Cartridge:
Test disc:
Lateral flow strip
Sample capillary with hemolysis vials or step dropper, 2 liquid reagents, pipette, cartridge
Ready to use
Add reagents to sample and disc
Shake reagents before taking sample

35. Hemocue 501 (OEM of Clover)
Competitor analysis II
Axis Shield Nycocard
Infopia Clover
Hemocue 501 (OEM of Clover)
Boditech i-CHROMA
Ceragem Labona Check™
Ceragem Cera-Stat 2000
Bio-Rad IN2IT
HumaMeter A1c
MEMORY: PATIENT & QUALITY CONTROL
7,000 P & QC
Last Patient
200 P
300 results
200 P & QC
REAGENT STORAGE
°C; thereof 90 days at room temperature
2 - 8°C 90 days at room temperature
Room temperature
2 - 8°C 20 months
2 - 8°C
2 - 8°C 30 days at room temperature
OPERATING CONDITIONS °C °C °C
°C; Humidity: %
PATIENT/USER ID
Yes No
Optional
No (Patient ID manual entry)
PRINTER
External
Integrated thermal printer
POWER AC
AC or DC9
AC or 12v battery
AC or 4 type AA batteries
battery
QUALITY CONTROL
2 levels
2 levels Must be diluted
SELF-TEST
During start up Optics check before each test
Calibration check
Check cartridge supplied
Optics check
PC INTERFACE
USB port
Serial port
Serial port, USB port
None

36. Hemocue 501 (OEM of Clover)
Competitor analysis III
Axis Shield Nycocard
Infopia Clover
Hemocue 501 (OEM of Clover)
Boditech i-CHROMA
Ceragem Labona Check™
Ceragem Cera-Stat 2000
Bio-Rad IN2IT
HumaMeter A1c
DEVICE CHARACTER-ISTICS
Multilingual display
DCCT reporting only
Dual reporting
Reporting either DCCT or IFCC, touch screen
Reporting either DCCT or IFCC and Hb, touch screen
Symbols and codes used on display
Dual Reporting, user selectable units % DCCT, mmol/mol IFCC, % JDS, eAG mg/dl and eAG mmol/l
Requires multiple pipette steps
OTHER ANALYSIS No
CRP, D-Dimer, Micro Albumin
Blood glucose Optional module
PSA, D-dimer, HS-CRP, TROP
Hemoglobin
APPROVALS CE
510(k)
CE CLIA waived
CLIA waived
MAXIMUM TIME PERMITTED AFTER BLOOD
7 minutes
30 seconds
5 minute
10 seconds
COLLECTION
SIZE AND WEIGHT
95x205x135 mm 0.7kg
200x170x170mm 0.54kg
200x200x139mm 1.4kg
185x80x250mm 1.3kg
178x195x77mm 0.73 kg
140x100x145mm 0.84kg
140x100x145mm 0.84 kg
OTHER
Easy operation Reagents stable at room temperature for 1 month
Multi-step manual process
OEM of Clover
Reagents stable for 20 months Multi step manual process
Updated nycocard with multi-step manual process
Noisy in use
Noisy in use Bulky cartridges take up lots of refrigerator space
Insert cartridge into machine then insert reagent pack with sample (2 steps instead of 1)
Bulky cartridges take up lots of fridge space
1 cartridge must be assembled

37. RECAP Name some of the most common causes of diabetes.
Name some of the symptoms of diabetes.
What does HumaMeter A1c measure?
Why must the reagent cartridges be removed from storage 40 minutes before use?
Which fingers should be used for taking a blood sample?
How long does HumaMeter A1c take to provide results?
HumaMeter A1c