Random Blood Glucose Estimation in Type 2 Diabetes: Does it Reflect Overall Glycaemic Control?

Abstract

The relationship between clinic-measured random blood glucose and glycated haemoglobin was investigated in 204 non-insulin-dependent diabetic patients to determine the value of random blood glucose on management decisions in these patients. Treatment was with diet alone in 104 patients (51%: Group 1), and diet and oral hypoglycaemic agents in 100 patients (49%: Group 2). Random blood glucose and glycated haemoglobin were lower in Group 1 than Group 2 (10.9 +/- 4.0 vs 13.0 +/- 4.0 mmol l-1, p < 0.001, and 8.5 (7.8-10.2) vs 9.6 (8.1-11.0)%, p < 0.01, respectively), and there was a positive correlation between random blood glucose and glycated haemoglobin in both groups (rGroup1 = 0.76, and rGroup2 = 0.54, both p < 0.001). In Group 1, 48 (46%) patients had a random blood glucose < 10 mmol l-1 and all but 2 of these had a glycated haemoglobin of < 10%. Thus, random blood glucose < 10 mmol l-1 was 96% sensitive for glycated haemoglobin < 10%. In Group 2 the same sensitivity was 92%. These data suggest that clinic-measured random blood glucose levels below 10.0 mmol l-1 predict acceptable overall glycaemic control in non-insulin-dependent diabetic patients, particularly in those on diet alone. However, a clinic-measured random blood glucose above 10 mmol l-1 was of limited value in predicting glycated haemoglobin values above 10% and a blood glucose cut-off of 14 mmol l-1 appeared more useful. Where resources are limited, clinic random blood glucose estimation may allow clinicians to use glycated haemoglobin measurements more discriminately.

Glycemic control in diabetic American Indians. Longitudinal data from the Strong Heart Study.

“…This phenomenon has been observed in several studies (26, 36,37) and may re flect the common clinical practice of placing This phenomenon has been observed in several studies (26, 36,37) and may re flect the common clinical practice of placing …”

Random blood glucose may be used to assess long‐term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

“…Gill et al . () and Gulliford () investigated British patients with type 2 DM and found that RBG<10.0 mmol/l had a high PPV (96%) for HbA 1c <10.0% but poor NPV (46%). An explanation for the variation in results could be that patients with type 2 DM in this study in general had a better glycaemic control than patients in the two previous studies.…”

“…Information on the diagnostic accuracy of RBG on long‐term glycaemic control is sparse, but two studies have shown that RBG had a high sensitivity or high positive predictive value (PPV) for suboptimal glycaemic control (HbA 1c : 7.8–10.0%) among patients with DM (Gill et al . ; Otieno et al . ).…”

Correlation between glycated haemoglobin and glucose testing for diabetes mellitus screening

“…Gill et al [9] suggested that clinic measured random blood glucose plasma levels below 10 mmol/L predict acceptable overall glycemic control in NIDDM patients, particularly on di et al one. A clinic measured random blood plasma glucose above 10 mmol/L was of limited value in predicting glycated hemoglobin values above 10% and a blood glucose cut off of 14 mmol/L is more useful.…”