Abstract
Objective: To assess the clinical utility of point of care (POC) capillary blood glucose (CBG) in the assessment of gestational diabetes (GDM) during oral glucose tolerance test (OGTT).
Design: Prospective cohort study.
Setting: Antenatal clinics at King’s College Hospital.
Population: Women screening for GDM between March and June 2020.
Methods: CBG was measured using POC-StatStrip® (Nova) and venous plasma glucose (VPG) was measured by Roche (Cobas 8000 c702) analyser. GDM was diagnosed based on NICE-2015 criteria. The two methods were compared statistically using Analyse-It (v 5.40.2)
Main outcome measures: Diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) for POC-StatStrip® compared to VPG measured by reference laboratory method.
Results: 230 women were included. The number and the percentage of women with glucose concentration above the GDM thresholds using POC-StatStrip® vs. Lab-VPG measurement was 15 (6.5%) vs. 8 (3.4%) at fasting and 105 (45%.6) vs. 72 (31.1%) at 2-hour respectively. Sensitivity, specificity and 95% CI for POC-StatStrip® were 88% (52-99) and 97% (93-98) at fasting and 97% (91-99) and 79% (71-84) at 2-hour respectively. However, the specificity and the NPV for POC-StatStrip® concentrations ≤5.0 mmol/L at fasting or <7.5mmol/L at 2-hour were 100% and the sensitivity and the PPV for concentration >9.5mmol/L at 2-hour was 100 %.
Conclusion: In our cohort POC-CBG measurement cannot entirely replace laboratory method in OGTT, however, it can be used to rule out/rule in GDM when the glucose concentrations are ≤5.0mmol/L at fasting or <7.5/>9.5mmol/L at 2-hour.
Design: Prospective cohort study.
Setting: Antenatal clinics at King’s College Hospital.
Population: Women screening for GDM between March and June 2020.
Methods: CBG was measured using POC-StatStrip® (Nova) and venous plasma glucose (VPG) was measured by Roche (Cobas 8000 c702) analyser. GDM was diagnosed based on NICE-2015 criteria. The two methods were compared statistically using Analyse-It (v 5.40.2)
Main outcome measures: Diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) for POC-StatStrip® compared to VPG measured by reference laboratory method.
Results: 230 women were included. The number and the percentage of women with glucose concentration above the GDM thresholds using POC-StatStrip® vs. Lab-VPG measurement was 15 (6.5%) vs. 8 (3.4%) at fasting and 105 (45%.6) vs. 72 (31.1%) at 2-hour respectively. Sensitivity, specificity and 95% CI for POC-StatStrip® were 88% (52-99) and 97% (93-98) at fasting and 97% (91-99) and 79% (71-84) at 2-hour respectively. However, the specificity and the NPV for POC-StatStrip® concentrations ≤5.0 mmol/L at fasting or <7.5mmol/L at 2-hour were 100% and the sensitivity and the PPV for concentration >9.5mmol/L at 2-hour was 100 %.
Conclusion: In our cohort POC-CBG measurement cannot entirely replace laboratory method in OGTT, however, it can be used to rule out/rule in GDM when the glucose concentrations are ≤5.0mmol/L at fasting or <7.5/>9.5mmol/L at 2-hour.
| Original language | English |
|---|---|
| Pages (from-to) | 1270-1278 |
| Number of pages | 9 |
| Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
| Volume | 131 |
| Issue number | 9 |
| Early online date | 18 Mar 2024 |
| DOIs | |
| Publication status | Published - Aug 2024 |
Keywords
- capillary blood glucose
- gestational diabetes mellitus
- oral glucose tolerance test
- point of care
- venous plasma glucose
