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April 28, 2021 / Brittany Cardwell, RDN, LD

Can At-Home Blood Tests Be as Good as In-Person?

Man in a blue shirt using an at-home blood test to prick his finger over a white table.

The COVID-19 pandemic has accelerated changes to the healthcare system including an evaluation of what medical services need to be offered in-person versus remotely.

Blood tests have been routinely performed in medical offices, per a physician’s recommendation, to evaluate overall health and monitor for certain diseases and medical conditions. Although at home lab testing is not a new concept, the pandemic has created a bigger push to move testing outside a doctor’s office.

While at home lab testing can be simple and convenient, a major concern arises over the accuracy–how does this compare to a standard lab and doctor’s visit? We’ll take a deeper look at some of the types of tests that are available at-home and how they compare to lab testing performed in-person by a trained clinician.

Why Would I Need an At-Home Blood Test?

Blood tests are typically ordered at least once a year as part of routine and preventative healthcare. This allows the patient and their care team to track changes in the body to optimize the person’s health and reduce the risk of disease. Some of the most common tests include:

A blood glucose test can help to identify abnormal blood glucose levels, which are indicative of diabetes. At-home blood tests can be a valuable tool for screening individuals for pre-diabetes and helping those already diagnosed with diabetes to better manage their disease. Knowing blood sugar levels are higher than normal can provide the motivation to follow a prediabetes diet plan to decrease the risk of developing diabetes.

How Do At-Home Blood Tests Work?

As the need for telemedicine and at-home lab testing increases, it’s helpful to understand how at-home blood tests work. Traditionally for in-person lab testing, a vial of blood is drawn from a vein in the arm by a trained clinician. With an at home blood test, a kit is ordered online and delivered to the person’s home with special instructions on how to conduct the test.

The blood sample is commonly collected through a fingerstick, which draws small droplets of blood from the capillaries in the finger. Depending on the at home lab test used, results may be immediate, but in many cases the sample needs to be sent away and analyzed in a lab to yield more accurate results. Once the sample is received at the lab, results are usually ready within 5-10 days and shared through a secure online platform.

Different Types of At-Home Blood Tests

The number of options for at-home bloods tests continues to rise along with the types of tests that are available. This increased accessibility gives people the opportunity to make more informed choices about their health. Let’s take a closer look at three types of tests we find helpful at PlateJoy Health.

HbA1c test

Hemoglobin A1C (HbA1c) is a protein that is found on the surface of red blood cells and can be tested to show the average amount of glucose (sugar) attached to the hemoglobin over the past three months. HbA1c shows a representation of blood sugar levels over time versus the level in a given hour. This test may be used to check for prediabetes in adults or evaluate how well a person has been maintaining their blood sugar levels for the past 90 days.

HbA1c test results are reported as percentages, with a higher percentage correlating to a higher average blood sugar level. A normal level is considered to be 5.6% or less. A level between 5.7% and 6.4% indicates prediabetes. Results of 6.5% or higher signal diabetes. Once diagnosed with diabetes, an A1c level of less than 7% is a common treatment target. This level is associated with a lower risk of developing diabetes-related complications.

An HbA1c test can be completed at-home with a kit requiring a small blood sample through a simple finger prick. Results are helpful for guiding lifestyle intervention to achieve ideal blood sugar levels.

Fasting insulin test

Another type of lab that is used to monitor for diabetes risk is a fasting insulin test. This is a test that measures the amount of insulin in the body, which is a hormone that helps to regulate the body’s blood sugar levels.

Insulin resistance occurs when the body’s cells stop responding normally to insulin, causing an elevation in blood sugar levels. If left untreated, over time the pancreas is no longer able to produce enough insulin to regulate blood sugar levels, which can progress to type 2 diabetes. A fasting insulin test can help identify insulin resistance, and if diagnosed early enough, can be treated with diet and exercise modifications. A normal fasting insulin level is between 2.6 and 24.9 mcIU/mL.

As the name suggests, an at home fasting insulin test does require an overnight fast (usually a minimum of eight hours) prior to collecting the blood sample. The sample is collected in a similar manner to the HbA1c test and should be mailed to a lab for analysis.

Lipid profile

A third type of test that can be used to check risks associated with modifiable risk factors (diet, exercise, stress, etc.) is a lipid profile. This test measures total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride levels which can be indicative of heart health. Goal lipid blood test values are as follows:

Individuals with insulin resistance and type 2 diabetes tend to have lipid abnormalities, a common condition called diabetic dyslipidemia. Lifestyle intervention can prevent or slow a lipid profile from going in the wrong direction and minimize a person’s risk for premature coronary heart disease and atherosclerosis. As with the insulin test, fasting is required before taking a blood sample at-home.

Difference Between an At-Home Blood Test and a Blood Test at a Lab

The obvious difference between an at-home blood test and a blood test at a lab is the location, but there are other variances to note, like how the blood sample is collected. An at-home blood test commonly involves a collection method called dried blood spot testing, which requires the use of a lancing device to draw a small amount of blood from the finger. Comparatively, when having blood collected at a lab or medical office, a larger sample is drawn from a vein in the arm by a phlebotomist, or someone who is trained to draw blood.

For blood draws done at a doctor's office or lab, large samples of blood may be needed depending on the test. However, at-home blood testing may be done with comparatively less blood (by volume).

The time taken to collect samples may also vary. Blood taken at an office may be a fairly quick process, as a medical professional does all the work to collect the patient's blood. However, since patients are responsible for collecting their own blood for an at-home test, this can be more time-consuming, requiring multiple finger pricks and dried blood spotting.

When doing an at-home test it’s important to read the kit instructions carefully to ensure the blood sample is collected properly. If not enough blood is collected–or not collected properly–the results may come back inconclusive or inaccurate.

Another difference between at-home lab tests and in-person testing is how they are ordered. A doctor’s referral is usually needed before having a blood test done at a lab, whereas many at-home blood tests can be ordered online without the approval of a doctor. Although this can make it easier to get blood tests done, at-home tests should never be used for self-diagnosis. Anyone ordering an at-home test should plan to discuss the results with a medical professional.

When ordering an at-home blood test, quality is important. Seek at-home lab testing that has been validated and reviews collected data in a certified lab.

It’s better to err on the side of caution when trusting the accuracy of these tests as they may not be as precise as when a larger sample is taken by a professional in a doctor’s office or clinic. Be sure to consult with a medical professional when interpreting any results.

The Takeaway

The purpose of blood testing is to detect and analyze a person's physical well-being. Complications of type 2 diabetes can be avoided, or significantly reduced, through controlling blood glucose and cholesterol levels. At-home blood testing makes it easier to bring awareness to a person’s risk of developing type 2 diabetes, which can be significantly reduced by following a diabetic meal plan and increasing physical activity. While at-home blood tests can be a convenient way to monitor your health, managing your health through a healthier lifestyle can also be easier with meal planning support from PlateJoy Health.

Brittany Cardwell, RDN, LD
Health Coach and Registered Dietitian Nutritionist @ PlateJoy

Brittany is a registered dietitian nutritionist with the Commission on Dietetic Registration and a licensed dietitian with the Ohio Board of Dietetics and the Tennessee Board of Dietitians. She is a graduate of Miami University (Ohio) with a Bachelor of Science in kinesiology and health, and holds a Certificate of Training in Adult Weight Management. An Ohio native, Brittany currently resides in Nashville with her husband, son and their fur baby. In her free-time she enjoys exploring new restaurants and coffee shops, attending barre classes and being outdoors.

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