Use of a reflectance photometer as a diabetes mellitus screening tool under field conditions.
OBJECTIVE
Investigate the Accu-Chek II and visual Chemstrip bG methods for non-insulin dependent diabetes mellitus (NIDDM) screening under field conditions with the aid of local providers.


METHODS
Compare simultaneous random Chemstrip bG, Accu-Chek II and plasma glucose levels using a 6.7 mM cut-off, followed by a 75 gram 2 hour oral glucose tolerance test while screening 1124 people in 15 Alaskan villages with the aid of local personnel during winter field conditions.


RESULTS
The Accu-Chek II and visual Chemstrip bG methods detected 92% and 96%, respectively, of those newly diagnosed with NIDDM whose plasma screen was > or = 6.7 mM. The Accu-Chek II provided correlations of 0.774, 0.850, 0.923, and 0.946 with random, fasting, 1 and 2 hour plasma glucose. The mean Accu-Chek II, Chemstrip bG and plasma levels at which NIDDM was diagnosed were not statistically different. Receiver operator characteristic (ROC) curve analysis revealed optimum screening cut-off values for subsequent new diagnosis of NIDDM to be 8.3, 7.7, and 8.0 mM for visual, Accu-Chek II and hexokinase methods (p = NS).


CONCLUSIONS
The Accu-Chek II and Chemstrip bG provided accurate glucose data in random NIDDM screening under field conditions with multiple local providers.
Murphy
N J
NJ
Alaska Native Health Service, Bethel.
Boyko
E J
EJ
Schraer
C D
CD
Bulkow
L R
LR
Lanier
A P
AP
D000328:Adult; D000413:Alaska / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003150:Community Health Workers; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011934:Reagent Strips; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D011934:Reagent Strips