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Ansari Moghadam S, Abbaszade H, Sartipi M, Ansari Moghadam A. Evaluating the association between gingival crevicular blood glucose levels and finger capillary blood glucose levels according to periodontal status. Eur J Med Res 2024; 29:86. [PMID: 38291508 PMCID: PMC10826020 DOI: 10.1186/s40001-023-01611-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/21/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the association between gingival crevicular blood glucose levels (GCBG) and finger capillary blood glucose levels (FCBG) according to the periodontal status of patients. MATERIALS AND METHODS In this case-control study, 80 patients were divided into 4 groups according to their periodontal status. In these patients, an area of the maxillary gingiva with the highest probing depth was selected for blood sampling. Blood glucose obtained from this area and the right fingertip was measured with a glucometer. Data were analyzed using ANOVA and Pearson correlation coefficient with a significance threshold of 0.05. RESULTS The groups studied were matched in regard to their sex and age (P > 0.05). The average FCBG and GCBG were not significantly different according to periodontal status (P > 0.05). The correlation between the FCBG and the GCBG showed a significant positive correlation in the total number of participants (P < 0.05, r = 0.531). CONCLUSION The study observed a positive association between GCBG and FCBG. However, the relationship with periodontal status appeared to be relatively weak. Further research may be needed to determine the potential efficacy of GCBG in diabetes screening during periodontal examinations. CLINICAL RELEVANCE Most patients with diabetes do not have proper periodontal health, so it may be helpful to screen for diabetes during periodontal examinations.
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Affiliation(s)
- Somaye Ansari Moghadam
- Department of Periodontology, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hanie Abbaszade
- Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohadeseh Sartipi
- Sri Rajiv Gandhi College of Dental Science & Hospital, Rajiv Gandhi University of Health Sciences, Bangalore, India.
| | - Alireza Ansari Moghadam
- Department of Health, Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Boriboonhirunsarn D, Robkhonburi A, Asad-Dehghan M. Accuracy of capillary blood glucose for 50-g glucose challenge test for gestational diabetes screening. Diabetol Int 2022; 13:561-5. [PMID: 35693996 DOI: 10.1007/s13340-022-00572-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
Purpose To assess the accuracy of capillary blood glucose (CBG) compared to conventional venous plasma glucose (VPG) testing for 50-g glucose challenge test (GCT) in gestational diabetes (GDM) screening. Methods A total of 300 women were enrolled and 50-g GCT for GDM screening was offered. At 1 h after glucose loading, CBG was evaluated by CONTOUR® PLUS glucose meter by well-trained nurses immediately after venipuncture for VPG. Results of CBG were compared with those from VPG to evaluate its accuracy. Women with venous plasma glucose > 140 mg/dL were offered 100-g OGTT for GDM diagnosis. Results The mean age was 30.2 years and the mean gestational age at testing was 21.8 weeks. GDM was diagnosed in 34 women (11.3%). The mean VPG was 142.1 ± 32.9 mg/dL and the mean CBG was 129.3 ± 33.5 mg/dL. Mean difference was -12.3 ± 12.5 mg/dL, corresponding to -8.8 ± 11.4%. CBG significantly correlated with VPG with correlation coefficient of 0.929, p < 0.001. In the detection of abnormal 50-g GCT results (VPG ≥ 140 mg/dL), at 126 mg/dL cutoff, CBG had sensitivity of 92.5%, specificity of 81.8%, and positive and negative predictive values of 82.8%and 92%. None of the GDM would have been missed if CBG was used. Conclusion CBG by a certified glucose meter could be considered as an alternative to conventional VPG testing for 50-g GCT for GDM screening using 126 mg/dL cutoff value.
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Costa PB, Ricarti ML, Augustavo CAA, Santos LS, Crivellenti LZ, Borin-Crivellenti S. Transoperative glycemia in pets: validating old ones, and presenting lip mucosa as new sampling site. Domest Anim Endocrinol 2021; 74:106540. [PMID: 32916522 DOI: 10.1016/j.domaniend.2020.106540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 11/23/2022]
Abstract
The aim of our study was to investigate the viability and validity of blood sampling from the upper lip mucosa in healthy dogs and cats for monitoring transoperative glycemia and compare the results with those obtained from samples taken from previously described blood sampling sites for determination of glycemia using a glucose meter. Blood glucose (BG) levels were determined in samples taken from the upper lip mucosa of 24 dogs and 31 cats undergoing neutering or spaying surgeries. These values were compared to those of samples obtained from other sites previously described for capillary blood glucose monitoring (marginal ear vein, carpal pad in dogs, metacarpal pad in cats) using a glucose meter. Additionally, BG from peripheral venous blood was determined using a glucose meter, and the gold standard enzymatic colorimetric assay. The clinical reliability of BG values taken from lip mucosa and from all the other BG values measured by the glucose meter was evaluated using the error grid analysis modified by Parkes et al (2000). The upper lip mucosa was an easily accessible site for the obtainment of appropriate blood samples, and glucose levels read in these samples correlated positively with glycemic values read in blood samples from all other sites in dogs and cats. All BG made using glucose meters taken from all sites were within the clinically acceptable range when compared with enzymatic colorimetric assay (gold standard), and were analytically accurate according to the error grid (zones A and B). All blood sampling sites described in this work can be used to assess transoperative glycemia. The upper lip mucosa is a viable blood sampling site for precise monitoring of transoperative glycemia in healthy dogs and cats and shows promise for alternative blood glucose monitoring.
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Affiliation(s)
- P B Costa
- Campus Glória - Bloco 1CCG SALA 211A, BR-050, KM 78, Uberlândia, Minas Gerais 38410-337, Brazil; Graduate Program in Veterinary Science (PPGCVET), Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - M L Ricarti
- Campus Glória - Bloco 1CCG SALA 211A, BR-050, KM 78, Uberlândia, Minas Gerais 38410-337, Brazil; College of Veterinary Medicine (FAMEV), Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - C A A Augustavo
- Campus Glória - Bloco 1CCG SALA 211A, BR-050, KM 78, Uberlândia, Minas Gerais 38410-337, Brazil; College of Veterinary Medicine (FAMEV), Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - L S Santos
- Laboratory of Veterinary Clinical Pathology, Veterinary Hospital (HV-UFU), Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - L Z Crivellenti
- Campus Glória - Bloco 1CCG SALA 211A, BR-050, KM 78, Uberlândia, Minas Gerais 38410-337, Brazil; College of Veterinary Medicine (FAMEV), Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - S Borin-Crivellenti
- Campus Glória - Bloco 1CCG SALA 211A, BR-050, KM 78, Uberlândia, Minas Gerais 38410-337, Brazil; Graduate Program in Veterinary Science (PPGCVET), Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil; College of Veterinary Medicine (FAMEV), Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil.
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Bonora E, Dauriz M, Rinaldi E, Mantovani A, Boscari F, Mazzuccato M, Vedovato M, Gallo A, Toffanin E, Lapolla A, Fadini GP, Avogaro A. Assessment of simple strategies for identifying undiagnosed diabetes and prediabetes in the general population. J Endocrinol Invest 2021; 44:75-81. [PMID: 32342446 DOI: 10.1007/s40618-020-01270-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/18/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS The rising tide of diabetes mellitus (DM) and prediabetes (PDM) is urgently calling for strategies easily applicable to anticipate diagnosis. We assessed the effectiveness of random capillary blood glucose (RCBG), administration of a validated DM risk questionnaire, or the combination of both. MATERIALS AND METHODS RCBG measurement and/or questionnaire administration were offered to all individuals presenting at gazebos organized during the World Diabetes Day or similar public initiatives on diabetes awareness. Subjects with suspicious DM or PDM were invited to the Diabetes Center (DC) for laboratory confirmation (fasting plasma glucose and HbA1c). RESULTS Among 8563 individuals without known diabetes undergoing RCBG measurement, 341 (4%) had suspicious values. Diagnosis of DM was confirmed in 36 (41.9%) of the 86 subjects who came to the DC and PDM was found in 40 (46.5%). Among 3351 subjects to whom the questionnaire was administered, 480 (14.3%) had suspicious scores. Diagnosis of DM was confirmed in 40 (10.1%) of the 397 who came to the DC and PDM was found in 214 (53.9%). These 3351 subjects also had RCBG measurement and 30 out of them had both tests positive. Among them, 27 subjects came to DC and DM was diagnosed in 17 (63.0%) and PDM was found in 9 (33.3%). CONCLUSIONS These data suggest that RCBG definitely outperforms the questionnaire to identify unknown DM and PDM. RCBG measurement, with questionnaire as an adjunctive tool, appears to be a simple, fast, and feasible opportunistic strategy in detecting undiagnosed DM and PDM.
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Affiliation(s)
- E Bonora
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Hospital Trust of Verona, Ospedale Maggiore, Piazzale Stefani, 1, 37126, Verona, Italy.
| | - M Dauriz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Hospital Trust of Verona, Ospedale Maggiore, Piazzale Stefani, 1, 37126, Verona, Italy
- Department of Internal Medicine, Section of Endocrinology and Diabetes, Bolzano General Hospital, Bolzano, Italy
| | - E Rinaldi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Hospital Trust of Verona, Ospedale Maggiore, Piazzale Stefani, 1, 37126, Verona, Italy
| | - A Mantovani
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Hospital Trust of Verona, Ospedale Maggiore, Piazzale Stefani, 1, 37126, Verona, Italy
| | - F Boscari
- Department of Medicine, University of Padua, Padua, Italy
| | - M Mazzuccato
- Department of Medicine, University of Padua, Padua, Italy
| | - M Vedovato
- Department of Medicine, University of Padua, Padua, Italy
| | - A Gallo
- Department of Medicine, University of Padua, Padua, Italy
| | - E Toffanin
- Department of Medicine, University of Padua, Padua, Italy
| | - A Lapolla
- Department of Medicine, University of Padua, Padua, Italy
| | - G P Fadini
- Department of Medicine, University of Padua, Padua, Italy
| | - A Avogaro
- Department of Medicine, University of Padua, Padua, Italy
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Proulx É, Auclair A, Piché ME, Harvey J, Pettigrew M, Biertho L, Marceau S, Poirier P. Safety of Blood Glucose Response Following Exercise Training After Bariatric Surgery. Obes Surg 2019; 28:3976-3983. [PMID: 30097897 DOI: 10.1007/s11695-018-3449-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Safety of exercise training in relationship with the risk of hypoglycemia post-bariatric surgery is unknown. OBJECTIVE To evaluate the safety and magnitude of changes in blood glucose levels during exercise training following bariatric surgery. MATERIAL AND METHODS Twenty-nine severely obese patients undergoing either sleeve gastrectomy (SG) (n = 16) or biliopancreatic diversion with duodenal switch (BPD-DS) (n = 13) were prospectively enrolled. Three months after surgery, patients participated in a 12-week supervised exercise training program, (35-min aerobic training with a 25-min resistance exercises) three times a week. Capillary blood glucose (CBG) levels were measured immediately before and after each exercise session. RESULTS Seven patients (24%) had type 2 diabetes before surgery (mean duration: 10 years); four patients still have type 2 diabetes 3 months post-bariatric surgery. A total of 577 exercise training sessions with CBG monitoring were recorded. Only seven sessions (1.2%) were associated with an episode of asymptomatic hypoglycemia (CBG ≤ 3.9 mmol/L). Patients with type 2 diabetes at baseline showed a larger decrease in CBG with pre-exercise CBG being between 6.1 and 8.0 mmol/L (- 1.6 ± 1.2 vs. - 1.1 ± 0.9 mmol/L, p = 0.02). BPD-DS patients with CBG ≥ 6.1 mmol/L showed higher reduction in CBG following exercise vs. SG patients (- 1.7 ± 1.0 vs. - 1.1 ± 1.1 mmol/L; p < 0.001 and - 4.3 ± 1.0 vs. - 2.2 ± 1.4 mmol/L, p < 0.001, respectively). CONCLUSION Three months after bariatric surgery, exercise training program in patients without and with type 2 diabetes is safe, and is associated with a desirable glycemic profile, with few episodes of asymptomatic hypoglycemia.
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Affiliation(s)
| | - Audrey Auclair
- Laval University, Québec, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada
| | - Marie-Eve Piché
- Laval University, Québec, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada
| | - Jany Harvey
- Laval University, Québec, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada
| | - Myriam Pettigrew
- Laval University, Québec, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada
| | - Laurent Biertho
- Laval University, Québec, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada
| | - Simon Marceau
- Laval University, Québec, Canada
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada
| | - Paul Poirier
- Laval University, Québec, Canada.
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada.
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Sayed M, Adnan F, Majeed M. Is HBA1C A True Marker Of Glycaemic Control In Diabetic Patients On Haemodialysis? J Ayub Med Coll Abbottabad 2019; 31:46-50. [PMID: 30868782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND HbA1c is generally conducted to check blood glucose control in diabetic patients. As reported by several recent studies, HbA1c may not be considered as a reliable assay for monitoring glycaemic status in haemodialysis patients. Multiple factors may result in artificially low HbA1c. We sought to confirm this observation by performing a study in which we saw the agreement between expected HbA1c values as indicated by the mean plasma glucose level and the measured HbA1c values of haemodialysis dependent Diabetic patients. METHODS This crosssectional study was conducted on 45 patients. Daily three readings of capillary blood glucose were taken for three consecutive days in a week, every two weeks in a month for up to three months. Total 54 capillary blood glucose levels were checked in the duration of three months. Mean blood glucose level was calculated at the end of the study and it is used to calculate the 'expected HbA1c' levels using a formula. At the offset, HbA1c was measured (at 12 weeks) and was compared with the expected HbA1c. RESULTS On comparing the expected and measured HbA1c levels in 45 patients on haemodialysis. There is a significant difference between the two levels, with reduced levels of measured HbA1c in majority of patients as compared to expected ones. CONCLUSIONS HbA1c is not a true marker of glucose control in diabetic patients on regular haemodialysis.
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Affiliation(s)
- Mehwish Sayed
- Department of Medicine, Liaquat National Hospital, Karachi, Pakistan
| | - Farzana Adnan
- Department of Medicine, Liaquat National Hospital, Karachi, Pakistan
| | - Muneeba Majeed
- Department of Medicine, Liaquat National Hospital, Karachi, Pakistan
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Blaurock MG, Kallner A, Menzel S, Masuch A, Nauck M, Petersmann A. Impact of Glucose Measuring Systems and Sample Type on Diagnosis Rates of Diabetes Mellitus. Diabetes Ther 2018; 9:2029-2041. [PMID: 30187227 PMCID: PMC6167283 DOI: 10.1007/s13300-018-0495-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The use of glucose point-of-care testing (POCT) devices for the diagnosis of diabetes mellitus (DM) is an ongoing controversy. In patient management, glucose concentrations are determined by POCT and core laboratory glucose methods, and the values are commonly compared even though the samples collected are different, namely, capillary whole blood and venous plasma. In individual patients it is difficult to distinguish between factors that can influence the results, such as sample type and measuring procedure. In this study, glucose concentrations obtained using POCT and core laboratory instruments were assessed to duplicate typical scenarios experienced in healthcare. Corresponding diagnosis rates of impaired glucose tolerance (IGT) and DM based on fixed, method-independent cutoffs were compared. METHODS Glucose concentration was measured by the 2-h oral glucose tolerance test (OGTT) in samples collected from an inpatient cohort and a cohort from the general population. Two POCT methods, namely, a handheld unit-use glucometer and a small bench-top analyzer with batch reagents, and two core laboratory procedures were used to measure glucose concentrations. The sample types were whole blood and plasma samples collected from venous and capillary blood. The glycated hemoglobin level in whole blood was also determined. RESULTS A total of 231 subjects were included in the study. The 2-h OGTT glucose concentrations in the capillary whole blood samples showed a positive bias of 0.8 mmol/L compared to those obtained using core laboratory plasma glucose methods, leading to increased rates of diabetes diagnosis. This bias decreased to 0.2 mmol/L when venous blood was used in the tests. A change in the method used by the core laboratory introduced a negative bias of 0.5 mmol/L and, consequently, a lower diagnosis rates. DISCUSSION AND CONCLUSION Venous blood samples measured at the point-of-care are the most suitable sample type for the measurement of the glucose concentration in the 2-h OGTT. The investigated unit-use POCT method is suitable for the diagnosis of IGT and DM when venous blood samples are collected. Importantly, changes in measurement procedures can introduce a bias and affect diagnosis rates, thereby emphasizing the need for further harmonization of glucose methods. A plain language summary is available for this article.
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Affiliation(s)
- Markus Gabriel Blaurock
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Anders Kallner
- Institute for Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Stefan Menzel
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Anaesthesiology, Dietrich-Bonhoeffer-Klinikum, Neubrandenburg, Germany
| | - Annette Masuch
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK e.V.), Berlin, Germany
| | - Astrid Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
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Bhavadharini B, Mahalakshmi MM, Maheswari K, Kalaiyarasi G, Anjana RM, Deepa M, Ranjani H, Priya M, Uma R, Usha S, Pastakia SD, Malanda B, Belton A, Unnikrishnan R, Kayal A, Mohan V. Use of capillary blood glucose for screening for gestational diabetes mellitus in resource-constrained settings. Acta Diabetol 2016; 53:91-7. [PMID: 25916215 PMCID: PMC4749644 DOI: 10.1007/s00592-015-0761-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/12/2015] [Indexed: 12/17/2022]
Abstract
AIMS The aim of the study was to evaluate usefulness of capillary blood glucose (CBG) for diagnosis of gestational diabetes mellitus (GDM) in resource-constrained settings where venous plasma glucose (VPG) estimations may be impossible. METHODS Consecutive pregnant women (n = 1031) attending antenatal clinics in southern India underwent 75-g oral glucose tolerance test (OGTT). Fasting, 1- and 2-h VPG (AU2700 Beckman, Fullerton, CA) and CBG (One Touch Ultra-II, LifeScan) were simultaneously measured. Sensitivity and specificity were estimated for different CBG cut points using the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for the diagnosis of GDM as gold standard. Bland-Altman plots were drawn to look at the agreement between CBG and VPG. Correlation and regression equation analysis were also derived for CBG values. RESULTS Pearson's correlation between VPG and CBG for fasting was r = 0.433 [intraclass correlation coefficient (ICC) = 0.596, p < 0.001], for 1H, it was r = 0.653 (ICC = 0.776, p < 0.001), and for 2H, r = 0.784 (ICC = 0.834, p < 0.001). Comparing a single CBG 2-h cut point of 140 mg/dl (7.8 mmol/l) with the IADPSG criteria, the sensitivity and specificity were 62.3 and 80.7 %, respectively. If CBG cut points of 120 mg/dl (6.6 mmol/l) or 110 mg/dl (6.1 mmol/l) were used, the sensitivity improves to 78.3 and 92.5 %, respectively. CONCLUSIONS In settings where VPG estimations are not possible, CBG can be used as an initial screening test for GDM, using lower 2H CBG cut points to maximize the sensitivity. Those who screen positive can be referred to higher centers for definitive testing, using VPG.
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Affiliation(s)
- Balaji Bhavadharini
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Manni Mohanraj Mahalakshmi
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Kumar Maheswari
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Gunasekaran Kalaiyarasi
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Mohan Deepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Harish Ranjani
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Miranda Priya
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Ram Uma
- Seethapathy Clinic and Hospital, Chennai, India
| | - Sriram Usha
- Associates in Clinical Endocrinology Education and Research (ACEER), Chennai, India
| | | | - Belma Malanda
- International Diabetes Federation, Brussels, Belgium
| | - Anne Belton
- International Diabetes Federation, Brussels, Belgium
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India.
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Jones GC, Casey H, Perry CG, Kennon B, Sainsbury CAR. Trends in recorded capillary blood glucose and hypoglycaemia in hospitalised patients with diabetes. Diabetes Res Clin Pract 2014; 104:79-83. [PMID: 24565213 DOI: 10.1016/j.diabres.2014.01.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/15/2013] [Accepted: 01/17/2014] [Indexed: 11/21/2022]
Abstract
AIMS To utilise whole-system analysis of capillary glucose measurement results to examine trends in timing of glucose monitoring, and to investigate whether these timings are appropriate based on observed patterns of hypoglycaemia. METHODS Near-patient capillary blood glucose results from eight acute hospitals collected over 57 months were analysed. Analysis of frequency of measurement, and measurements in the hypoglycaemic (<4mmol/l) and severe hypoglycaemic (<2.5mol/l) range per time of day was made. RESULTS 3345241 capillary glucose measurements were analysed. 1657594 capillary blood glucose values were associated with 106624 admissions in those categorised as having diabetes. Large peaks in frequency of glucose measurements occurred before meals, with the highest frequency of capillary glucose measurement activity being seen pre-breakfast. Overnight, an increase in measurement activity was seen each hour. This pattern was mirrored by frequency of measured hypoglycaemia. 27968 admissions (26.2%) were associated with at least one hypoglycaemic measurement. A greater proportion of measurements were within the hypoglycaemic range overnight with 61.7% of all hypoglycaemia between 2100 and 0900h, with peak risk of measured capillary glucose being hypoglycaemic between 0300 and 0400h. CONCLUSIONS Hypoglycaemic is common with the greatest risk of hypoglycaemia overnight and a peak percentage of all readings taken being in the hypoglycaemic range between 0300 and 0400h. Measurement activity overnight was driven by routine, with patterns of proportion of measurements in the hypoglycaemic range indicating that there may be a significant burden of undiscovered hypoglycaemia in the patients not routinely checked overnight.
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Affiliation(s)
- G C Jones
- Department of Diabetes, Gartnavel General Hospital, Glasgow G11 0YN, United Kingdom.
| | - H Casey
- Department of Diabetes, Gartnavel General Hospital, Glasgow G11 0YN, United Kingdom
| | - C G Perry
- Department of Diabetes, Gartnavel General Hospital, Glasgow G11 0YN, United Kingdom
| | - B Kennon
- Department of Diabetes, Southern General Hospital, Glasgow G51 4TF, United Kingdom
| | - C A R Sainsbury
- Department of Diabetes, Gartnavel General Hospital, Glasgow G11 0YN, United Kingdom
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