Type 2 Diabetes Screening in Pharmacy: Capillary Blood Glucose and HbA1c

Type 2 diabetes is a chronic disease with increasing prevalence and is often underdiagnosed. From the pharmacy, we have a unique opportunity to contribute to its early detection, improving our patients' quality of life and reducing associated complications. Did you know that we can be a fundamental pillar in screening for this pathology?

The Role of the Pharmacy in Early Diabetes Detection

The community pharmacy is an accessible and trusted healthcare point for the population. This accessibility strategically positions us to actively participate in screening programmes for chronic diseases, such as type 2 diabetes. Early detection is crucial, as it allows for the initiation of dietary, exercise, and pharmacological interventions before serious complications such as neuropathies, retinopathies, or nephropathies appear.

Our work is not limited to dispensing medicines; it also encompasses health education, pharmacotherapeutic follow-up, and the performance of screening tests. By identifying people at risk or with altered values, we can refer them to a doctor for appropriate diagnosis and management, acting as an essential filter in the healthcare system. This proactive approach is fundamental for public health.

Capillary Blood Glucose: A Quick First Approach

Measuring capillary blood glucose is a simple, quick, and minimally invasive tool that we can perform in the pharmacy. Although not diagnostic in itself, it is very useful for identifying people with elevated glucose levels who may need a more in-depth medical evaluation. It is recommended to perform it fasting (after 8 hours without food intake) or randomly.

A fasting capillary blood glucose value greater than 100 mg/dL or a random value greater than 140 mg/dL in people with no previous diagnosis of diabetes should alert us and prompt referral to a doctor. It is important to remember that factors such as stress, recent food intake, or certain medications can influence the results, so we must always interpret the data with caution and offer comprehensive pharmaceutical care.

Glycated Haemoglobin (HbA1c): A Key Indicator

Glycated haemoglobin (HbA1c) is a parameter that reflects the average blood glucose levels over the last 2-3 months. Unlike capillary blood glucose, it is not affected by daily fluctuations or recent food intake, which makes it a more stable and reliable indicator for diabetes screening and monitoring. The Spanish Medicines and Medical Devices Agency (AEMPS) and the EMA recognise its value in diagnosis. (Readers should check with their own national regulator for regulatory information).

In the pharmacy, we can determine HbA1c using portable devices that require a small capillary blood sample. An HbA1c value equal to or greater than 6.5% is diagnostic of diabetes, while values between 5.7% and 6.4% indicate prediabetes. The Spanish Society of Family and Community Medicine (SemFyC) and the Spanish Society of Community Pharmacy (SEFAC) recommend its use in screening at-risk populations. It is essential that, in the event of any altered result, the patient is referred to their doctor for diagnostic confirmation and establishment of a therapeutic plan.

Referral Criteria and Interprofessional Collaboration

Our role in screening is to identify, inform, and refer. We must never diagnose or prescribe treatments. Criteria for referring a patient to a doctor after pharmacy screening include:

• Fasting capillary blood glucose ≥ 100 mg/dL on two occasions.
• Random capillary blood glucose ≥ 140 mg/dL.
• HbA1c ≥ 5.7%.
• Presence of symptoms suggestive of diabetes (polyuria, polydipsia, polyphagia, unexplained weight loss, blurred vision, recurrent infections).
• Additional risk factors (family history, obesity, hypertension, dyslipidaemia, sedentary lifestyle).

Collaboration with primary care centres is essential. Fluid communication and the use of standardised reports facilitate continuity of care and ensure that the patient receives appropriate attention. The pharmacy is a key link in the health chain, and our involvement in type 2 diabetes screening is a clear example of how we can improve community health. For more information on how to optimise your pharmacy's management, you can consult our pharmacy agreement 2026.