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Evaluating the utility of a point‐of‐care glucometer for the diagnosis of gestational diabetes
Author(s) -
Adam Sumaiya,
Rheeder Paul
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12399
Subject(s) - medicine , gestational diabetes , gold standard (test) , obstetrics , diabetes mellitus , point of care testing , prospective cohort study , pregnancy , gestation , endocrinology , pathology , genetics , biology
Objective To investigate the performance of the Roche Accuchek Active glucometer in diagnosing gestational diabetes mellitus ( GDM ) versus the gold‐standard laboratory test. Methods In a prospective cohort observational study at a primary healthcare clinic in Johannesburg, South Africa, pregnant women, excluding known diabetics, were recruited between 2013 and 2016. A 75‐g 2‐hour oral glucose tolerance test ( OGTT ) was scheduled at 24–28 gestational weeks. Glucose was measured in venous blood (laboratory) and capillary blood (glucometer). GDM was diagnosed via FIGO criteria. Diagnostic accuracy was evaluated by calculating the sensitivity, specificity, and coefficient of variance ( CV ) of the glucometer test, and by Bland‐Altman plots. Results Data from 529 women were analyzed. Of these, 141 (26.7%) and 79 (14.9%) were diagnosed with GDM by laboratory and glucometer measurements, respectively. The CV of the glucometer ranged from 15% to 17%. Bland‐Altman plots showed a positive bias of the glucometer results at 0 hours, but a negative bias at 1 and 2 hours of the OGTT . The sensitivity and specificity of the glucometer for the diagnosis of GDM were 27.0% and 89.4%, respectively. Conclusion Use of the Roche Accuchek Active glucometer for the diagnosis of GDM cannot be recommended.