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


METHODS
Prospective study.


METHODS
A tertiary care, university hospital in Bangkok, Thailand.


METHODS
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.
Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. sispv@mahidol.ac.th
S
S
Ngerncham
S
S
Piriyanimit
T
T
Kolatat
P
P
Wongsiridej
L
L
Inchgarm
R
R
Kitsommart
P
P
Vutrapongwatana
K
K
Jeerapaet
D001774:Blood Chemical Analysis / Q000295:instrumentation* / Q000592:standards; D001786:Blood Glucose / Q000032:analysis*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood*; D015997:Neonatal Screening / Q000295:instrumentation* / Q000592:standards; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013785:Thailand
D001786:Blood Glucose