Capillary blood glucose screening (Accu-Chek Advantage) for gestational diabetes.
OBJECTIVE
To determine optimal threshold of capillary blood glucose screening (Accu-Chek Advantage) for gestational diabetes.


METHODS
A cross-sectional analytical study.


METHODS
Capillary and venous blood of pregnant women who attended the antenatal clinic at Trang Regional Hospital between August 2007 and May 2008 were collected for glucose testing (by approach of American Diabetes Association's Fourth International Workshop-Conference on Gestational Diabetes) at one hour after taking 50 gm glucose. The glucose values of Accu-Check Advantage were compared with the standard venous plasma glucose. The receiver operator characteristic (ROC) curve was created to determine the optimal threshold of the capillary blood test screening for gestational diabetes.


RESULTS
A total of 816 pregnant women were enrolled in the present study. Their capillary blood glucose values and plasma glucose values were checked with the Accu-Chek Advantage and the central laboratory chemistry analyzer respectively. The good correlation between capillary blood glucose and plasma glucose values was found (correlation coefficient = 0.80, 95% CI 0.77-0.82). There was a significant difference in the average values of capillary blood and plasma blood (134.1 vs. 122.7 mg/dl, respectively). When the data were analyzed by ROC curve, the optimal level of capillary blood by Accu-Chek Advantage for performing a 100 gm oral glucose tolerance test was 140 mg/dl (reference plasma glucose level of at least 140 mg/dl). The sensitivity specificity likelihood ratio for a positive test result and likelihood ratio for a negative test result were 93.8%, 83.6%, 5.71 and 0.07, respectively. The potential advantages of capillary blood glucose screening are simple to use, cheap and convenient.


CONCLUSIONS
Accu-Chek Advantage is suitable for screening gestational diabetes using the optimal threshold capillary glucose level of 140 mg/dl.
Department of Obstetrics and Gynecology, Trang Regional Hospital, Muang, Trang, Thailand. Thana_rat@hotmail.com
Thanarat
T
Srimaekarat
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis*; D003940:Diagnostic Techniques, Endocrine / Q000295:instrumentation; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation*; D011247:Pregnancy; D012372:ROC Curve; D055815:Young Adult