Performance of a Blood Glucose Monitoring System in a Point-of-Care Setting

Utility of point-of-care vs reference laboratory testing for the evaluation of glucose levels

AIMS

To assess the level of agreement between point-of-care and laboratory reference glucose values in defining glycaemic status.

METHODS

We analysed 1292 overweight/obese, non-institutionalized participants, aged 40-65 years, in the San Juan Overweight Adults Longitudinal Study. Fasting venous blood glucose was determined using a point-of-care Bayer Contour Blood Glucose Meter and by Vitros System 250 instrument (laboratory). American Diabetes Association thresholds were used to classify participants into normoglycaemia (< 5.6 mmol/l), prediabetes (5.6 to 6.9 mmol/l), or diabetes groups (≥ 7 mmol/l).

RESULTS

Bland-Altman plot analysis showed a slope of 0.04 (P=0.002) for the regression between the mean difference and the average of the two methods. The slopes were significantly different from zero among people with normoglycaemia (β=-0.57, P<0.001), and prediabetes (β=-0.75, P<0.001) but not among people with diabetes (β=-0.02, P=0.68). When the prediabetes and diabetes groups were merged into one group, the slope was 0.01, and the glucose values remained similar using the two methods (P=0.76).

CONCLUSION

Point-of-care blood glucose measurement may be useful to screen people with diabetes, and to assess glucose among individuals with diabetes where blood can be drawn, but laboratory tests are unavailable or untimely.

The real world of blood glucose point-of-care testing (POCT) system running in China teaching hospital

BACKGROUND

 The blood glucose point-of-care testing (POCT) system is important in the decision-making process involving patients suspected of having hypoglycemia. To investigate the real world of the POCT system being used in teaching hospitals in China.

METHODS

The survey was conducted by Hisend Research Group from May 2015 to July 2015 in four teaching hospitals in China. The survey questions were referred to the ISO 15197:2013 standard requirements for the use of the POCT system in a hospital setting.

RESULTS

A total of 170 subjects were included from 4 hospitals, which included nursing staff, nurse unit managers, employees from the department of medical instruments, and staff members employed by the clinical laboratories in the Tianjin Metabolism Hospital, Nanjing First Hospital, First Affiliated Hospital of Dalian Medical University, and the First hospital affiliated with the Xi'an Transportation University. The average score for the four hospitals surveyed in this study was 66.6, which varied from 46.1 to 79.7. The main factors influencing the scores were the multiple choices of blood-glucose meters, and the quality control assessment.

CONCLUSION

Our data indicates that the real world use of the POCT system in hospital settings in China needs more closer adherence to a quality management framework.

Requirements for Successful Adoption of a Glucose Measurement System Into a Hospital POC Program

Widespread and successful implementation of any glucose measurement system in a hospital point-of-care (POC) program requires a number of features in addition to accurate and reliable analytical performance. Such features include, but are not limited to, a system's glucose-hematocrit dependence, durability, information technology capabilities, and battery capacity and battery life. While the study of Ottiger et al in this issue supports the analytical accuracy and reliability of Bayer's CONTOUR XT® blood glucose monitoring system, the suitability of other features of this system for a hospital POC program remains to be established.