Accuracy evaluation and comparison of three blood glucose meters in An Emergency Paediatric Unit of a Tertiary Hospital in Nigeria

Abstract

Backgrounds: Advances in technology have made available different types of glucose meters for use at the patient's bed side with significant
variation in accuracy among these glucose meters.
Objectives: We evaluated the accuracy of three commonly used glucose meters in a children emergency room using laboratory method as reference.
Subjects: Subjects were 206 children seen in emergency room over a period of 3 months.
Methods: Capillary blood glucose was determined at the bed side using three glucose meters: Accu - Chek® Active, On Call® Plus and One Touch®
Ultra Mini. Peripheral venous blood was simultaneously collected for comparative plasma glucose analysis at the laboratory. The mean absolute relative deviations (MARDs) were determined. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.
Results: The MARD for Accu - Chek® Active, On Call® Plus and One Touch® Ultra Mini were 11.58%, 27.00%, and 13.91% respectively. In the diagnosis of hyperglycaemia, the sensitivity and specificity for Accu - Chek® Active, On Call® Plus, One Touch® Ultra Mini were 83.3% and 96.3%, 94.4% and 79.3%, 94.4 and 94.7% respectively. The PPV and NPV for Accu - Chek® Active, On Call® Plus, One Touch® Ultra Mini were 68.1% and 98.4%, 30.4% and 99.3%, 62.9% and 99.4% respectively. Four cases of hypoglycaemia were detected by the laboratory method and the 3 glucose meters detected 3 out of the 4 correctly.
Conclusion: These three glucose meters varied in accuracy but the glucose values by the Accu - Chek® Active had the least variation from the
laboratory results.

Key Words: Glucose meter, hyperglycaemia, hypoglycaemia, Dysglycaemia, Emergency Paediatric Unit.