Objective: To determine the accuracy and reliability of a glucometer in comparison to hexokinase method in detecting neonatal hypoglycemia.
Design: Comparative analytical study.
Place and duration of study: Neonatal Unit of the Children ' Hospital, Lahore from August 2001 to February 2002.
Subjects and methods: All neonates presenting with known risk factors or suggestive clinical features were screened for hypoglycemia by using capillary blood on Accutrend alpha glucometer. Simultaneously the venous blood glucose values were done on Hitachi 902 autoanalyser by hexokinase method. A level of 40 mg/dl or less was taken as neonatal hypoglycemia.
Results: A total of 292-paired samples were taken from 223 neonates. Hypoglycemia was detected in 112 samples (38.4%). Correlation of glucometer values with laboratory values of blood glucose levels was excellent throughout the range with coefficient of correlation (r) of 0.976 (p-value < 0.001). For blood glucose values < 40 mg/dl, r was 0.547 (p-value < 0.001). The instrument used showed a sensitivity of 98% and specificity of 93% to detect neonatal hypoglycemia (< 40 mg/dl) with a positive predictive value of 88% and negative predictive value 99%.
Conclusion: The blood glucose reflectance meter can be a useful and accurate instrument for screening and detecting neonatal hypoglycemia in symptomatic babies under stress. All low values by glucometer should be promptly analyzed and confirmed by chemical laboratory.