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

Abstract

Background: Hypoglycaemia occurs in many disease states 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: hypoglycaemia, children, bedside investigation, glucose estimation, blood glucose.