COMPARATIVE STUDY OF GLUCOMETER AND LABORATORY GLUCOSE OXIDASE METHOD FOR THE ESTIMATION OF BLOOD GLUCOSE LEVELS IN NEONATES

• Published in: Journal of evolution of medical and dental sciences Vol. 4; no. 16; pp. 2652 - 2663
• Main Authors: Harish, J, Srinivas, H.A, Soumya, A
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 23.02.2015
• Subjects: Analysis; Blood sugar; Glucose monitors; Health aspects; Infants (Newborn)
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2015/383

INTRODUCTION: Hypoglycemia is one of the most common metabolic problems encountered in neonates. Hypoglycemia in neonates can be symptomatic and asymptomatic. Hypoglycemia is known to be associated with brain dysfunction and neuromotor developmental retardation. The glucose oxidase method used in the laboratory for determining the blood glucose concentration is precise and specific for glucose. As it is usually performed in the main laboratory, the results are not available quickly enough for timely appropriate management. The glucometers are often used for blood glucose estimation in NICU. Many studies have shown that their results co-relate well with the laboratory measured glucose levels in the normoglycemic and hyperglycemic range but are not satisfactory in the lower range. OBJECTIVES: This is a prospective study done to determine the efficacy of glucometer in estimation of blood glucose levels in neonates in comparison with the laboratory values. METHODS: 250 neonates admitted in NICU, KIMS hospital, Bangalore with varied symptomatology were enrolled in this study. Blood glucose estimation was done by glucometer and laboratory method using the same venous sample at the time of admission. For the last 50 cases glucometer estimation of capillary blood was also done. Statistical analysis was done by using Pearson correlation. Hypoglycemia was defined as blood glucose level <45mg%. Laboratory value was taken as gold standard. RESULTS: The study enrolled 250 neonates of which 63.2% were males and 36.8% were females. 103 cases [41.2%] were found to be hypoglycemic by lab values while 52 [20.8%] were found to be hypoglycemic by glucometer. The overall incidence of hypoglycemia in our study was 41.2%. 49.7% of the LBW babies were found to be hypoglycemic while only 12% of normal birth weight babies were hypoglycemic. 31.3% of term babies were hypoglycemic while 55.3% of preterms were hypoglycemic. Hypoglycemia was common in neonates with risk factors like prematurity, meconium aspiration, septicemia, birth asphyxia etc. Glucometer had a specificity of 93.88%, sensitivity of 41.75%, positive predictive value of 82.69%, negative predictive value of 69.70% and accuracy of 72.4%.The correlation between the glucometer and laboratory values is good when the gold standard value i.e. lab value is >45mg% [0.756] and when the value is <45mg%, there is just a moderate correlation [0.417]. Though the pick-up rate of hypoglycemia by venous blood glucometer [28%] was slightly better compared to the capillary blood glucometer value [22%], the overall pick-up rate of hypoglycemia by glucometer is very low compared to the laboratory method [56%]. CONCLUSION: The glucometer as a sole measuring device to screen neonatal hypoglycemia is not satisfactory and confirmation with the laboratory measurements of plasma glucose is still of up most importance. KEYWORDS: Hypoglycemis, neonates, glucometer, glucose oxidase method.