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- Title
Use of point-of-care glucometers during an oral glucose tolerance test in children for prediabetes and diabetes diagnosis: a comparison study.
- Authors
Fabre-Estremera, Blanca; Martínez-Chávez, Estéfani; Manzano Ocaña, Marta; Carcavilla Urquí, Atilano; Morales Sánchez, María de los Ángeles; Pinilla Tejado, Inmaculada; González-Casado, Isabel; Losantos García, Itsaso; Fernández-Calle, Pilar; Buño Soto, Antonio; Oliver, Paloma
- Abstract
Despite clinical guidelines do not recommend the use of point-of-care testing (POCT) glucometers for diagnostic purposes yet, the analytical performance is continuously improving. Thus, we evaluate the technical accuracy and clinical concordance of POCT glucometers during an oral glucose tolerance test (OGTT) in children for prediabetes and diabetes diagnosis in a comparison study. Pediatric patients with an OGTT indication who attended the Diabetes Unit between December 2020 and September 2021 were recruited for this prospective observational study. During the functional test, glycaemia was immediately measured in venous blood using two glucometers (unconnected and connected) and sent to the central laboratory. The study included 98 patients. There was a high correlation between the glucometers and the central laboratory (Pearson correlation coefficient=0.912 and 0.950, for unconnected and connected glucometer, respectively). The median OGTT turnaround time (TAT) was significantly decreased (connected glucometer: 2.02 h [interquartile range, 2.00–2.07], central laboratory: 11.63 h [6.09–25.80]), with similar overall cost. The diagnostic concordance between connected glucometer and the central laboratory was 71.1 % (95 % confidence interval (CI) 61.5–79.2). The clinical decision would have been the same in the 92.8 % of the cases, but treatment would have not been indicated in 4 patients (4.1 %). POCT glucometers have demonstrated a high correlation and an acceptable diagnostic concordance with the central laboratory during an OGTT, as well the connected device offers a significant decrease in TAT, without increasing costs. However, as severe clinical impact could happen, POCT glucometers may not be used for diagnosis yet.
- Subjects
DIAGNOSIS of diabetes; PREDIABETIC state; STATISTICAL correlation; PEARSON correlation (Statistics); TURNAROUND time; BLOOD sugar monitors; GLYCOLYSIS; GLUCOSE tolerance tests; RESEARCH evaluation; SCIENTIFIC observation; LABORATORIES; QUESTIONNAIRES; DESCRIPTIVE statistics; DECISION making in clinical medicine; DIAGNOSTIC errors; PEDIATRICS; LONGITUDINAL method; RESEARCH; POINT-of-care testing; COMPARATIVE studies; CONFIDENCE intervals; MEDICAL care costs; CHILDREN
- Publication
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio, 2024, Vol 5, Issue 2, p189
- ISSN
2628-491X
- Publication type
Article
- DOI
10.1515/almed-2023-0089