Evaluating the validity of a bedside method of detecting hypoglycemia in children.
BACKGROUND
Hypoglycemia in the pediatric age group is a common finding associated with a wide variety of disorders. It often presents urgent diagnostic and therapeutic challenges. In the tropics where facilities for laboratory evaluation are inadequate and inefficient, there is need to evaluate alternative methods of diagnosis.


OBJECTIVE
The aim of the study was to validate the glucometer method of assessing hypoglycemia in pediatric patients.


METHODS
Four hundred fifty-three consecutively admitted patients were recruited into the study. After a detailed history and thorough physical examination, 2 mL of blood was obtained from each patient. A drop was put on the test strip, and plasma glucose level read off a glucometer. The remainder was sent to the laboratory for comparative plasma glucose determination by the glucose oxidase method. Hypoglycemia was defined as plasma glucose less than 2.5 mmol/L (<45 mg/dL).


RESULTS
Out of the 453 studied, only 392 (86.5%) had complete results and were included in the analysis. Thirty-eight (9.7%) were hypoglycemic by the glucometer method, but only 25 (6.4%) of them were hypoglycemic by the laboratory method. The glucometer was found to be highly sensitive and specific, and its results compares favorably with the laboratory values. The glucometer gave a predictive index of a positive test as 63.12% and of a negative test as 99.72%. It however leads to overdiagnosis of hypoglycemia.


CONCLUSIONS
The glucometer was found to be highly sensitive and specific, and its result correlates significantly well with the laboratory method. The glucometer method for blood sugar determination in emergency cases is highly recommended in children.
Elusiyan
Jerome Boluwaji Elutayo
JB
Department of Pediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria. bimbolabanks@yahoo.com
Adeodu
Olugbenga O
OO
Adejuyigbe
Ebunoluwa A
EA
D001786:Blood Glucose / Q000032:analysis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D007223:Infant; D008297:Male; D019095:Point-of-Care Systems
D001786:Blood Glucose