Skip to main content
Log in

Validity of two point-of-care glucometers in the diagnosis of neonatal hypoglycemia

  • Research Paper
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To estimate validity of two point-of-care glucometers for the diagnosis of neonatal hypoglycemia and to determine the glucometer’s cut-off values for which standard laboratory confirmatory test are no longer needed.

Design

Prospective study.

Settings

A tertiary care, university hospital in Bangkok, Thailand.

Participants

The study included 180 blood specimens from 166 high-risk neonates aged between 1–24 hours.

Results

On average, most of the blood glucose read-outs from the Nova StatStrip and SureStep were higher than laboratory plasma glucose throughout the glucose range with mean differences (SD) of 11.2 (8.4) mg/dL and 13.7 (6.8) mg/dL, respectively. Sensitivity of Nova StatStrip and SureStep were 62% and 53.3%, respectively. Specificity and positive predictive value of both glucometers were 100%. Negative predictive values of both glucometers were approximately 85%. The cut-off levels with 100% negative predictive values were 63 mg/dL and 62 mg/dL for Nova StatStrip and SureStep, respectively.

Conclusions

None of the glucometers in this study has sufficient validity to replace laboratory testing in diagnosing hypoglycemia. Confirmatory plasma glucose for diagnosis of hypoglycemia is needed when POC readings are between 39 and 63 mg/dL for Nova StatStrip and between 39 and 62 mg/dL for SureStep.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Burns CM, Rutherford MA, Boardman JP, Cowan FM. Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics. 2008;122:65–74.

    Article  PubMed  Google Scholar 

  2. Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000;105:1141–1145.

    Article  PubMed  CAS  Google Scholar 

  3. Innanen VT, DeLand ME, deCampos FM, Dunn MS. Point-of-care glucose testing in the neonatal intensive care unit is facilitated by the use of the Ames Glucometer Elite electrochemical glucose meter. J Pediatr. 1997;130:151–155.

    Article  PubMed  CAS  Google Scholar 

  4. Leonard M, Chessall M, Manning D. The use of a Hemocue blood glucose analyser in a neonatal unit. Ann Clin Biochem. 1997;34:287–290.

    PubMed  Google Scholar 

  5. Girouard J, Forest JC, Masse J, Leroux M, Bradburn NC, Noblet TC, et al. Multicenter evaluation of the Glucometer Elite XL meter, an instrument specifically designed for use with neonates. Diabetes Care. 2000;23:1149–1153.

    Article  PubMed  CAS  Google Scholar 

  6. Ho HT, Yeung WK, Young BW. Evaluation of “point of care” devices in the measurement of low blood glucose in neonatal practice. Arch Dis Child Fetal Neonatal Ed. 2004;89:F356–F359.

    Article  PubMed  CAS  Google Scholar 

  7. Michel A, Kuster H, Krebs A, Kadow I, Paul W, Nauck M, et al. Evaluation of the Glucometer Elite XL device for screening for neonatal hypoglycaemia. Eur J Pediatr. 2005;164:660–664.

    Article  PubMed  Google Scholar 

  8. Holtzinger C, Szelag E, Dubois JA, Shirey TL, Presti S. Evaluation of a new POCT bedside glucose meter and strip with hematocrit and interference corrections. Point of Care. 2008;7:1–6.

    Google Scholar 

  9. Scher MS. Seizures in neonates. In: Martin RJ, Fanaroff AA, Walsh MC, editors. Fanaroff and Martin’s neonatalperinatal medicine: diseases of the fetus and infant. Philadelphia: Mosby Elsevier; 2006. p. 956–976.

    Google Scholar 

  10. Mahoney JJ, Ellison JM. Assessing glucose monitor performance-a standardized approach. Diabetes Technol Ther. 2007;9:545–552.

    Article  PubMed  CAS  Google Scholar 

  11. Sacks DB, Bernhardt P, Dunka LJ, Goldstein DE, Hortin GL, Mueller P. Point-of-Care Blood Glucose Testing in Acute and Chronic Care Facilities; Approved Guideline. 2002. Available from: URL: http://www.clsi.org/source/orders/free/c30-a2.pdf.Accessed on March 24, 2011.

  12. American Diabetes Association. Self-monitoring of blood glucose. Diabetes Care. 1994;17:81–86.

    Google Scholar 

  13. Adamkin DH. Postnatal glucose homeostasis in latepreterm and term infants. Pediatrics. 2011;127:575–579.

    Article  PubMed  Google Scholar 

  14. World Health Organization. Use of anticoagulants in diagnostic laboratory investigations 2002; Available from: URL: http://whqlibdoc.who.int/hq/2002/WHO_DIL_LAB_99.1_Rev.2.pdf. Accessed on March 24, 2011.

  15. Chan AY, Swaminathan R, Cockram CS. Effectiveness of sodium fluoride as a preservative of glucose in blood. Clin Chem. 1989;35:315–317.

    PubMed  CAS  Google Scholar 

  16. Gambino R, Piscitelli J, Ackattupathil TA, Theriault JL, Andrin RD, Sanfilippo ML, et al. Acidification of blood is superior to sodium fluoride alone as an inhibitor of glycolysis. Clin Chem. 2009;55:1019–1021.

    Article  PubMed  CAS  Google Scholar 

  17. Mann EA, Salinas J, Pidcoke HF, Wolf SE, Holcomb JB, Wade CE. Error rates resulting from anemia can be corrected in multiple commonly used point-of-care glucometers. J Trauma. 2008;64:15–20.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sopapan Ngerncham.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ngerncham, S., Piriyanimit, S., Kolatat, T. et al. Validity of two point-of-care glucometers in the diagnosis of neonatal hypoglycemia. Indian Pediatr 49, 621–625 (2012). https://doi.org/10.1007/s13312-012-0133-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-012-0133-2

Key words

Navigation