Point-of-care testing of capillary glucose in the exclusion and diagnosis of diabetes in remote Australia
| Autor: | Kerryn Coleman, Julia V. Marley, Stephanie Davis, Greg Brennan, Bradleigh D Hayhow, David Atkinson, Jacki Mein, Carmel Nelson, Graeme P. Maguire |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Native Hawaiian or Other Pacific Islander Adolescent National Health Programs Point-of-care testing Concordance Point-of-Care Systems Population Reference laboratory Gastroenterology Internal medicine Diabetes mellitus medicine Humans Community Health Services education Blood Glucose Measurement Child Aged Glycated Hemoglobin education.field_of_study business.industry Clinical Laboratory Techniques Glucose Measurement General Medicine Venous blood Western Australia Middle Aged medicine.disease Endocrinology Cross-Sectional Studies Diabetes Mellitus Type 2 Female Rural Health Services business |
| Zdroj: | The Medical journal of Australia. 186(10) |
| ISSN: | 0025-729X |
| Popis: | 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 (ρ = 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 ≥ 12.2 mmol/L (sensitivity, 83.3%; specificity, 99.3%; positive-predictive value, 95.2%; for a venous value of ≥ 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. |
| Databáze: | OpenAIRE |
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