Blood glucose measurement by glucometer in comparison with standard method in the diagnosis of hypoglycemia in sick neonates
Abstract
Hypoglycemia is a serious risk factor in neonates. The signs and symptoms are non-specific. Early diagnosis is essential to reduce the associated morbidity and mortality.
Objective: To determine the efficacy and correlation of capillary and venous bedside glucose estimation using a glucometer in comparison with laboratory blood glucose analysis by glucose oxidase method in sick hypoglycemic neonates.
Methods: Blood glucose estimation was done in 200 sick neonates admitted to NICU by glucometer and by glucose oxidase method in the laboratory using the same venous sample at the time of admission. In addition, glucose estimation of capillary blood was also done using the same glucometer. Statistical analysis was done by Pearson correlation.
Results: The incidence of hypoglycemia in sick neonates by laboratory analysis was 15.5%. When laboratory values were used as gold standard, capillary blood glucose estimates had a sensitivity of 74.19%, specificity of 98.2%, PPV of 88.4% and NPV of 95.4%,whereas venous blood glucose estimates had a sensitivity of 93.55%, specificity of 98.23%, PPV of 90.62% and NPV of 98.8% in identifying hypoglycemia by glucometer in sick neonates.
Conclusion: Venous and capillary blood glucose estimation by glucometer has a good sensitivity and negative predictive value in detecting hypoglycemia in sick neonates. Further, the sensitivity of glucometer using venous blood is superior to capillary sample estimates. Laboratory blood glucose estimation should still be performed if bedside venous or capillary blood glucometer values are in the hypoglycemic range.
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References
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