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Med J Aust. 2007 May 21;186(10):500-3.

Point-of-care testing of capillary glucose in the exclusion and diagnosis of diabetes in remote Australia.

Author information

1
The Rural Clinical School of Western Australia, The University of Western Australia, Broome, WA, Australia. Julia.Marley@uwa.edu.au

Abstract

OBJECTIVES:

To determine the utility of point-of-care (POC) capillary blood glucose measurements in the diagnosis and exclusion of diabetes in usual practice in primary health care in remote areas.

DESIGN:

Cross-sectional study comparing POC capillary glucose results with corresponding venous glucose levels measured in a reference laboratory.

PARTICIPANTS:

200 participants aged 16-65 years enrolled: 198 had POC capillary glucose measurements; 164 also had acceptable venous glucose laboratory results.

SETTING:

Seven health care sites in the Kimberley region of Western Australia from May to November 2006.

MAIN OUTCOME MEASURES:

Concordance and mean differences between POC capillary blood glucose measurement and laboratory measurement of venous blood glucose level; POC capillary blood glucose equivalence values for excluding and diagnosing diabetes, and their sensitivity, specificity and positive-predictive value.

RESULTS:

The concordance between POC and laboratory results was high (rho=0.93, P<0.001). The mean difference in results was 0.48 mmol/L (95% CI, 0.23-0.73; limits of agreement, - 2.6 to 3.6 mmol/L). The POC capillary glucose equivalence values for excluding and diagnosing diabetes were < 5.5 mmol/L (sensitivity, 53.3%; specificity, 94.4%; positive-predictive value, 88.9%; for a venous value of < 5.5 mmol/L) and >or= 12.2 mmol/L (sensitivity, 83.3%; specificity, 99.3%; positive-predictive value, 95.2%; for a venous value of >or= 11.1 mmol/L), respectively. While the choice of glucometer and whether or not patients were fasting altered these results, they did not have a significant influence on the diagnostic utility of POC glucose measurement in this setting.

CONCLUSION:

POC capillary blood glucose analysers can be used as part of the process of diagnosing and excluding diabetes in remote rural communities using these locally established capillary equivalence values.

PMID:
17516895
[Indexed for MEDLINE]
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