scholarly journals Validation of Point-of-Care Glucose Testing for Diagnosis of Type 2 Diabetes

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Marijana Vučić Lovrenčić ◽  
Vanja Radišić Biljak ◽  
Sandra Božičević ◽  
Edita Pape-Medvidović ◽  
Spomenka Ljubić
Keyword(s):  
Glucose Tolerance ◽  
Point Of Care ◽  
Previous History ◽  
Blood Sampling ◽  
Oral Glucose ◽  
Reference Laboratory ◽  
Diabetes Diagnosis ◽  
Sample Type ◽  
Glucose Testing ◽  
Glucose Meter

Point-of-care (POC) glucose technology is currently considered to be insufficiently accurate for the diagnosis of diabetes. The objective of this study was to investigate the diagnostic accuracy of an innovative, interference-resistant POC glucose meter (StatStrip glucose hospital meter, Nova Biomedical, USA) in subjects with a previous history of dysglycaemia, undergoing a 75 g diagnostic oral glucose tolerance test (oGTT). Venous and capillary blood sampling for the reference laboratory procedure (RLP) and POC-glucose measurement was carried out at fasting and 2 h oGTT, and categories of glucose tolerance were classified according to 2006 WHO diagnostic criteria for the respective sample type. We found an excellent between-method correlation at fasting (r=0.9681,P<0.0001) and 2 h oGTT (r=0.9768,P<0.0001) and an almost perfect diagnostic agreement (weighted Kappa = 0.858). Within a total of 237 study subjects, 137 were diagnosed with diabetes with RLP, and only 6 of them were reclassified as having glucose intolerance with POC. The diagnostic performance of POC-fasting glucose in discriminating between the normal and any category of disturbed glucose tolerance did not differ from the RLP (P=0.081). Results of this study indicate that StatStrip POC glucose meter could serve as a reliable tool for the diabetes diagnosis, particularly in primary healthcare facilities with dispersed blood sampling services.

scholarly journals Prior exercise alters the difference between arterialised and venous glycaemia: implications for blood sampling procedures

2017 ◽  
Vol 117 (10) ◽  
pp. 1414-1421 ◽  
Author(s):  
Robert M. Edinburgh ◽  
Aaron Hengist ◽  
Harry A. Smith ◽  
James A. Betts ◽  
Dylan Thompson ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Sampling Methods ◽  
Venous Blood ◽  
Blood Sampling ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Post Exercise ◽  
Sampling Procedures ◽  
Venous Plasma

AbstractOral glucose tolerance and insulin sensitivity are common measures, but are determined using various blood sampling methods, employed under many different experimental conditions. This study established whether measures of oral glucose tolerance and oral glucose-derived insulin sensitivity (insulin sensitivity indices; ISI) differ when calculated from venous v. arterialised blood. Critically, we also established whether any differences between sampling methods are consistent across distinct metabolic conditions (after rest v. after exercise). A total of ten healthy men completed two trials in a randomised order, each consisting of a 120-min oral glucose tolerance test (OGTT), either at rest or post-exercise. Blood was sampled simultaneously from a heated hand (arterialised) and an antecubital vein of the contralateral arm (venous). Under both conditions, glucose time-averaged AUC was greater from arterialised compared with venous plasma but importantly, this difference was larger after rest relative to after exercise (0·99 (sd 0·46) v. 0·56 (sd 0·24) mmol/l, respectively; P<0·01). OGTT-derived ISIMatsuda and ISICederholm were lower when calculated from arterialised relative to venous plasma and the arterialised–venous difference was greater after rest v. after exercise (ISIMatsuda: 1·97 (sd 0·81) v. 1·35 (sd 0·57) arbitrary units (au), respectively; ISICederholm : 14·76 (sd 7·83) v. 8·70 (sd 3·95) au, respectively; both P<0·01). Venous blood provides lower postprandial glucose concentrations and higher estimates of insulin sensitivity, compared with arterialised blood. Most importantly, these differences between blood sampling methods are not consistent after rest v. post-exercise, preventing standardised venous-to-arterialised corrections from being readily applied.

Point-of-Care Glucose Testing

2000 ◽  
Vol 124 (2) ◽  
pp. 257-266 ◽  
Author(s):  
Richard F. Louie ◽  
Zuping Tang ◽  
Demetria V. Sutton ◽  
Judith H. Lee ◽  
Gerald J. Kost
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Center ◽  
Point Of Care ◽  
Reference Method ◽  
Glucose Levels ◽  
Glucose Testing ◽  
Primary Reference ◽  
Glucose Meter

Abstract Objective.—To assess the clinical performance of glucose meter systems when used with critically ill patients. Design.—Two glucose meter systems (SureStepPro and Precision G) and a modular adaptation (Immediate Response Mobile Analysis-SureStepPro) were assessed clinically using arterial samples from critically ill patients. A biosensor-based analyzer (YSI 2700) and a hospital chemistry analyzer (Synchron CX-7) were the primary and secondary reference instruments, respectively. Patients and Setting.—Two hundred forty-seven critical care patients at the University of California, Davis, Medical Center participated in this study. Outcome Measures.—Error tolerances of ±15 mg/dL for glucose levels ≤100 mg/dL and ±15% for glucose levels &gt;100 mg/dL were used to evaluate glucose meter performance; 95% of glucose meter measurements should fall within these tolerances. Results.—Compared to the primary reference method, 98% to 100% of SureStepPro and 91% to 95% of Precision G measurements fell within the error tolerances. Paired differences of glucose measurements versus critical care variables (Po2, pH, Pco2, and hematocrit) were analyzed to determine the effects of these variables on meter measurements. Po2 and Pco2 decreased Precision G and SureStepPro measurements, respectively, but not enough to be clinically significant based on the error tolerance criteria. Hematocrit levels affected glucose measurements on both meter systems. Modular adaptation did not affect test strip performance. Conclusions.—Glucose meter measurements correlated best with primary reference instrument measurements. Overall, both glucose meter systems showed acceptable performance for point-of-care testing. However, the effects of some critical care variables, especially low and high hematocrit values, could cause overestimated or underestimated glucose measurements.

scholarly journals Clusters of Glycemic Response to Oral Glucose Tolerance Tests Explain Multivariate Metabolic and Anthropometric Outcomes of Bariatric Surgery in Obese Patients

2019 ◽  
Vol 8 (8) ◽  
pp. 1091 ◽  
Author(s):  
Lukasz Szczerbinski ◽  
Mark A. Taylor ◽  
Anna Citko ◽  
Maria Gorska ◽  
Steen Larsen ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Glucose Tolerance ◽  
Principal Component ◽  
Oral Glucose ◽  
Diabetes Diagnosis ◽  
Oral Glucose Tolerance ◽  
Clustering Methods ◽  
Multinomial Regression ◽  
Oral Glucose Tolerance Tests ◽  
Glucose Tolerance Tests

Glycemic responses to bariatric surgery are highly heterogeneous among patients and defining response types remains challenging. Recently developed data-driven clustering methods have uncovered subtle pathophysiologically informative patterns among patients without diabetes. This study aimed to explain responses among patients with and without diabetes to bariatric surgery with clusters of glucose concentration during oral glucose tolerance tests (OGTTs). We assessed 30 parameters at baseline and at four subsequent follow-up visits over one year on 154 participants in the Bialystok Bariatric Surgery Study. We applied latent trajectory classification to OGTTs and multinomial regression and generalized linear mixed models to explain differential responses among clusters. OGTT trajectories created four clusters representing increasing dysglycemias that were discordant from standard diabetes diagnosis criteria. The baseline OGTT cluster increased the predictive power of regression models by over 31% and aided in correctly predicting more than 83% of diabetes remissions. Principal component analysis showed that the glucose homeostasis response primarily occurred as improved insulin sensitivity concomitant with improved the OGTT cluster. In sum, OGTT clustering explained multiple, correlated responses to metabolic surgery. The OGTT is an intuitive and easy-to-implement index of improvement that stratifies patients into response types, a vital first step in personalizing diabetic care in obese subjects.

Sign in / Sign up

Export Citation Format

Share Document