Is the Accuchek glucometer reliable to evaluate the neonatal hypoglycemia?
Takfallah L (Ms.C)
Midwifery education center .Azad University of Semnan. Scientific Panel Member
Abstract:
Introduction:
Hypoglycemia is the most prevalent problem seen in neonates that can lead to irreversible brain damages if not to be cured soon.
Today, the blood glucose is mostly checked by laboratory methods that have a significant delay and can result in many adverse effects such as vessel rupture. This study aims whether the glucometer device of Accuchek is reliable to check the blood glucose in hypoglycemic neonatal samples as a rapid and low-risk method in order to replace the laboratory method.
Method & Materials:
This was a descriptive cross-sectional study that evaluated 120 high-risk neonates in Amiralmomenin hospital (Semnan-Iran).Their blood glucose level were simultaneously checked via the Accuchek glucometer and the laboratory method of glucose-oxidase (as gold standard method), hereby the data related to neonatal risk factors were inserted into a preplanned check-list. We waited until the laboratory glucose level to be reported. If BS≤35 mg/dl (first 2 hours of birth) BS≤40 mg/dl (2-24 hours after birth) and BS≤45 mg/dl (more than 24 hours after birth); the supposed neonates (30 samples) estimated as hypoglycemic and inserted into the 2nd stage of this study then their simultaneous glucose levels reported with the Accuchek, were analyzed using SPS software and regression in a meaningful level of 5%. Also we calculated specificity and sensitivity of the Accuchek by using the ROC curve.
RESULTS
The laboratory mean blood glucose levels of the hypoglycemic and normoglycemic(control) groups were 39.61 +/- 5.67 mg/dl and 81.07+/- 35.56 mg/dl respectively. The glucometry mean blood glucose levels of the hypoglycemic and normoglycemic(control) groups were 39.68 +/- 7.50 mg/dl and 74.8+/- 30.15 mg/dl respectively. The blood glucose levels extracted from both laboratory and glucometry methods had a positive correlation R=0.865(P<0.000). The blood glucose level ≤45 mg/dl showed sensitivity of 90% and specificity of 84% whereby BS=46 mg/dl was calculated as CUT-OFF with the maximum specificity (88%) and sensitivity (86%) based on the ROC curve.
Conclusion:
This study shows that the simultaneous laboratory and glucometry blood glucose levels have a positive and tight correlation (R=0.865) and BS=46 mg/dl has the maximum specificity and sensitivity that recommends the Accuchek device to replace the laboratory method as a simpler method at the blood glucose level ≤46 mg/dl.
