Evaluating the blood glucose measured via glucometry in diagnosis of hypoglycemia in neonates

Hypoglycemia is one of the most prevalent problems seen in neonates and can lead to irreversible brain damage if not to be diagnosed in time. Today, the blood glucose is mostly checked by laboratory methods that have a significant delay and can result in many adverse effects such as vessel rupture. The goal of this study was to evaluate the value of the glucometry device in diagnosis of hypoglycemia in neonates.

This study has been conducted over 156 hospitalized neonates in Amir al momenin Hospital, Semnan, Iran. The blood glucose in all cases has been simultaneously measured by both laboratory methods (glucose oxidase as the golden standard) and glucometer. These measurements along with the relevant data for neonatal risk factors were recorded in the checklist. The blood glucose measurements of less than or equal 35 mg/dL in first two hours after birth, less than or equal 40mg/dL in 3 to 24 hours after birth, less than or equal 45 mg/dL in more than 24 hours after birth are considered as hypoglycemic.

58 neonates (37.2%) were hypoglycemic.The measurement of blood glucose levels via glucometer for hypoglycemia detection had a high precision (Area under curve = 0.941, Standard error =0.018, P= 0.0001). The optimum cut-off point yielded to equivalent of 51mg/dL. So that for fasting blood glucose of less than or equal 51mg/dL, sensitivity, specificity, positive, and negative predictive values were, respectively, 94.7%, 81.6%, 75.3%, and 96.4%.

Findings show that, blood glucose levels measured by glucometry have good accuracy for diagnosis of hypoglycemia in newborns. Thus, it is recommended that in case of screening and frequent need of monitoring neonatal blood glucose, this device be used as a suitable replacement of laboratory methods.