Evaluation of three glucometers for whole blood glucose measurements at the point of care in preterm or low-birth-weight infants

Abstract

PurposeWe evaluated three blood glucose self-monitoring for measuring whole blood glucose levels in preterm and low-birth-weight infants.MethodsBetween December 1, 2012 and March 31, 2013, 230 blood samples were collected from 50 newborns, who weighed, ≤2,300 g or were ≤36 weeks old, in the the neonatal intensive care unit of Eulji University Hospital. Three blood glucose self-monitoring (A: Precision Pcx, Abbott; B: One-Touch Verio, Johnson & Johnson; C: LifeScan SureStep Flexx, Johnson & Johnson) were used for the blood glucose measurements. The results were compared to those obtained using laboratory equipment (D: Advia chemical analyzer, Siemens Healthcare Diagnostics Inc.).ResultsThe correlation coefficients between laboratory equipment and the three blood glucose self-monitoring (A, B, and C) were found to be 0.888, 0.884, and 0.900, respectively. For glucose levels≤60 mg/dL, the correlation coefficients were 0.674, 0.687, and 0.679, respectively. For glucose levels>60 mg/dL, the correlation coefficients were 0.822, 0.819, and 0.839, respectively. All correlation coefficients were statistically significant. And the values from the blood glucose self-monitoring were not significantly different from the value of the laboratory equipment , after correcting for each device's average value (P>0.05). When using laboratory equipment (blood glucose ≤60 mg/dL), each device had a sensitivity of 0.458, 0.604, and 0.688 and a specificity of 0.995, 0.989, and 0.989, respectively.ConclusionSignificant difference is not found between three blood glucose self-monitoring and laboratory equipment. But correlation between the measured values from blood glucose self-monitoring and laboratory equipment is lower in preterm or low-birth-weight infants than adults.

Automated Microfluidic System with Active Mixing Enables Rapid Analysis of Biomarkers in 5 μL of Whole Blood

“…As noted earlier, the detection of glucose from microliter volumes of blood is particularly relevant for neonatology where instances of hypoglycemia are frequent. Traditional electrochemical glucometers are well suited for the analysis of small blood volumes but are inaccurate at glucose levels below 2 mM. , In this paper, we chose to focus on the enzymatic colorimetric assay for glucose detection. As shown in Figure A, this is a multistep assay where glucose breakdown is catalyzed by glucose oxidase (GOx) and leads to the production of H 2 O 2 , which, in turn, is oxidized by HRP.…”

“…These biosensors or glucometers require a finger prick of blood (<2 μL) and provide an answer within seconds. However, they are not accurate when measuring glucose levels <2 mM and may also be affected by variability in hematocrit levels. , Subcutaneous continuous glucose monitoring systems may be used in neonates but present a variety of issues, from low accuracy to causing discomfort and inflammation. , Therefore, despite the fact that glucose monitoring is routine and very successful in adults, there is a need for technologies that are geared toward neonatal applications.…”

Automation and Computerization of (Bio)sensing Systems

“…The commercially available electrochemical glucometers are capable of analyzing the glucose levels in whole blood samples and provide a numerical value within seconds. However, they exhibit inaccuracies when analyzing glucose levels <2 mM due to the inherent variability in hematocrit levels. − Traditionally, centrifugation has been employed for separating plasma from whole blood samples. Nevertheless, in recent years, microfluidic devices emerged as a viable technique for separating plasma from whole blood, particularly in small volumes. , An integrated on-chip plasma separation module (PSM) for an automated microfluidic device was developed by Gonzalez-Suarez et al The PSM enables the analysis of glucose levels in microliter volumes of blood (Figure -I-A,B).…”

Risk factors associated with hypoglycemia in neonates

“…Este defecto de los glucómetros se debe a que fueron diseñados para adultos y sobre todo para detectar hiperglucemias. Por ello, la Asociación Americana de Diabetes ha fijado que los glucómetros tengan un error <10% con respecto a la medición en laboratorio con rangos de (13,14) glucemia entre 30 y 400 mg/dL . La medición de la glucemia varía además con la hemoglobina de los RN: la anemia genera falsas hiperglicemias y la poliglobulia baja las lecturas de los glucómetros.…”