Reliability of bedside blood glucose estimating methods in detecting hypoglycaemia in the children’s emergency room

Abstract

Background: Hypoglycaemia occurs in many diseasestates common in the tropics. Facilities and skilled manpower required for laboratory blood glucose measurement are not always available in health facilities in developing countries. Objective: The study was carried out to determine the validity of bedside methods of blood glucose measurement in detecting hypoglycaemia. Methods: Blood glucose was determined by two bedside methods (Accuchek Active® and Betachek Visual®) in 430 patients aged between one month and 10years and simultaneously sent for laboratory spectrophotometric analysis at a wavelength of 500nm using the hexose kinase method. Hypoglycaemia was defined as plasma glucose < 2.5mmol/L. Results: The prevalence of hypoglycaemia was 5.6%.There was a higher correlation (r =0.84, p<0.05) between Accuchek Active® results and laboratory values than was obtained with Betachek Visual® (r = 0.48, p=0.000).In detection of hypoglycaemia, both bedside glucose monitors were found to have a high specificity and high predictive values of a negative test (99.8% and 98.5% for Accuchek Active® and 89.4% and 97.8% for Betachek Visual® respectively) with moderate sensitivity (75.0% and 66.7% respectively). However, the Accuchek Active® monitor has a much higher predictive value of a positive test (94.1%) compared to the Betachek Visual® (27.1%). Conclusion: The bedside glucose monitors are valid bedside tools for detecting or ruling out hypoglycemia.

Keywords

• ypoglycaemia
• children
• bedside investigation
• glucose estimation
• blood glucose