Random Capillary Blood Glucose Research Articles

The Negative Association Between Traditional Physical Activities and the Prevalence of Glucose Intolerance in Alaska Natives

The once low prevalence of non-insulin-dependent (Type 2) diabetes (NIDDM) in Eskimos and Indians has risen approximately fourfold over the past 30 years, suggesting the presence of a non-genetic factor affecting NIDDM prevalence. At the same time, traditional physical activities required of a subsistence (self-sufficiency) lifestyle have diminished. Since physical activity has been shown to prevent NIDDM in other populations, we performed a case–control study of physical activity and glucose intolerance in 666 Yup'ik Eskimos and Athabaskan Indians ≥40 years old in 15 villages in the Yukon Kuskokwim Delta in Alaska. Self-administered questionnaires were used to determine whether subjects participated in a number of traditional activities and/or their modern counterpart (for example, dog sledding and riding motorized vehicles). Intensity values and a score were defined for the activities. Cases included known or newly discovered impaired glucose tolerance or NIDDM. Newly discovered cases were defined by oral glucose tolerance testing of those individuals were screening blood glucose values ≥6.7 mmol l−1 by random capillary blood glucose testing. Cases included 11 newly discovered (1 with a history of IGT) and 26 known cases of NIDDM, and 17 newly discovered and 1 known cases of IGT. The results showed that, compared to a reference group with low-level physical activity, moderate level physical activity (odds ratio, OR, 0.7, 95 % confidence interval [CI] 0.4–1.3) and high level activity (OR 0.2, CI 0.1–0.6) were associated with a lower prevalence of glucose intolerance, adjusted for age, ethnicity, body mass index, and sex.

Screening for diabetes mellitus in adults. The utility of random capillary blood glucose measurements.

Because half of the people with non-insulin-dependent diabetes mellitus (NIDDM) are undiagnosed and because near-normal glycemic control can prevent diabetic complications, we evaluated the use of field-based random capillary blood glucose measurement as a screening test for NIDDM. A cross-sectional sample of 828 Egyptians > or = 20 years of age underwent both a random capillary blood glucose measurement performed with a portable reflectance meter in the field and an oral glucose tolerance test in the laboratory. The sensitivity and specificity of random capillary blood glucose measurements in predicting the presence of NIDDM were evaluated. Multivariate analyses showed that the screening test performed better when subjects had eaten shortly before the test (area under receiver operating characteristic curve, 0.87 for a 1-h postprandial period compared with 0.69 for an 8-h postprandial period) and that the optimal capillary blood glucose cutoff points to define a positive test increased with age. For a postprandial period of 1 h, cutoff points of 115 mg/dl for individuals 30 years of age and 140 mg/dl for those 75 years of age yielded similar performance characteristics (sensitivity 82% and specificity 78% for those 30 years old; sensitivity 81% and specificity 80% for those 75 years old). Adjusting random capillary blood glucose measurements for the postprandial period and using age-specific cutoff point values can improve performance of the screening test.

Random capillary whole blood glucose test as a screening test for diabetes mellitus in a middle-aged population.

This study was aimed at assessing the adequacy of a random capillary whole blood glucose (RCBG) test as a screening test for diabetes mellitus in a middle-aged (55-year-old) Finnish population. Both the screening test (RCBG) and a standard 2-h oral glucose tolerance test (OGTT) were performed on all the participants according to the WHO criteria. The prevalence based on the 2-h OGTTs was 8.5% (11.7% for men and 6.0% for women). The sensitivity, specificity and predictive values of the screening test for diabetes and the receiver operator characteristic (ROC) curves were studied. The likelihood ratios for diabetes within the test categories were also calculated. When a cut-off point of 6.2 mmol l-1 was used, which proved to be the most appropriate in the present study, the specificity was 92% and the sensitivity 63% (79% for men and 40% for women). The men had much higher sensitivities than the women at all cut-off points, but the specificities were comparable. The present study indicated that the RCBG test could be used as a screening test in a subpopulation with a high prevalence of diabetes and severe hyperglycaemia, but it would be quite insensitive in a subpopulation with a considerable overlap of RCBG values between the diabetic group and the non-diabetic one. It would be inappropriate to use the RCBG test as a routine screening test for diabetes in a general population, particularly among subjects with a known low prevalence of diabetes.

Random capillary whole blood glucose test as a screening test for diabetes mellitus in an elderly population

We assessed the adequacy of the random capillary whole blood glucose (RCBG) test as a screening test for estimating the prevalence of diabetes mellitus in an elderly Finnish population (aged 70 years or over). Both the screening test and a standard 2 h oral glucose tolerance test made according to the WHO criteria were administered to all participants. By using a cut-off point of 7.4 mmol/l for men, 7.1 mmol/l for women and 7.2 mmol/l for the total population, the RCBG test determined the prevalence of diabetes accurately. The prevalence determined by the RCBG test was 25.8% (men 21.0% and women 28.6%) and that determined by the 2 h oral glucose tolerance test 26.1% (men 21.7% and women 28.6%). The study also indicated that the RCBG levels elevated with the increase of the severity and duration of diabetes and with the presence of hypertension. The conclusion is that the RCBG test with a proper cut-off point is an optimal test for the estimation of the prevalence of diabetes and that the other properties of the test should be assessed according to the clinical outcomes and later signs of the disease.

Random Blood Glucose Values in the Last Trimester of Pregnancy

Sixty-nine Kuwaiti and 115 non-Kuwaiti Arab women with gestational ages ≧ 25 weeks were screened using a reflectance photometer to determine random capillary blood glucose (RCBG). All known diabetics

A model for early diagnosis of type 2 diabetes mellitus in primary health care.

The aim of the study was to determine the feasibility of conducting a case-finding programme for Type 2 diabetes mellitus in primary health care and to see whether random urinary glucose or random capillary blood glucose testing is the most suitable instrument for the early detection of Type 2 diabetes. Residents in the community of Låxa aged 35-64 years were subjected to testing during 1983-1987; those aged 65-79 were included from July 1985 and onwards. The urinary glucose testing was considered positive if a urinary dipstick was not unequivocally negative. The random blood glucose test was regarded as positive when > or = 8.0 mmol l-1. A diagnosis of Type 2 diabetes made within a follow-up period of 3 years from the initial examination was regarded as a positive outcome. Random blood glucose testing was performed on 3268 persons which was close to 85% of the eligible population. Urinary glucose tests were missing in 67 subjects. The random blood glucose test was positive in 220 persons and the urinalysis in 42 persons. A total of 234 individuals had a positive test, out of which 66 new diabetic cases were found. Sixty-four of these were detected by the random blood glucose testing and 20 by the urinalysis. The sensitivity for the random blood glucose and urinary glucose testing was 73 and 23%, the specificity was 95 and 99%, the positive predictive value 29 and 48%, and the negative predictive value 99 and 98%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

The Value of Screening for Diabetes in Patients with Skin Sepsis

Four hundred and eighty-two patients with spontaneous skin and superficial sepsis and 291 controls of similar age and sex underwent random capillary blood glucose measurements in order to assess whether screening for diabetes in patients presenting with skin sepsis to an Accident & Emergency Department detects a greater number of cases than that present in the background population. All subjects with a concentration > 7.8 mmol/l were subsequently followed up with a 75 g oral glucose tolerance test. Forty-two (8.7%) of the 482 skin sepsis patients had a capillary blood glucose > 7.8 mmol/l compared to eight (2.7%) of the 291 without sepsis (chi 2 = 9.71, P < 0.002). Of these, 26 of the skin sepsis group and 7 of the control group attended for follow up. Of those who attended, 13 of the skin sepsis group had an abnormal glucose tolerance test (seven diabetes, six impaired glucose tolerance-IGT) compared to two (one diabetes, one IGT) of the control group (chi 2 = 2.87, P < 0.1). The difference in cases of frank diabetes between the two groups was not statistically significant. Of the total eight diabetic cases identified, five (on direct questioning) had symptoms of hyperglycaemia (thirst, polyuria and/or weight loss) and two of the others were obese, one of whom had documented ischaemic heart disease. Thus, while most cases of diabetes in patients with skin sepsis could be detected by specifically asking about hyperglycaemic symptoms and performing a blood glucose estimation when these are present, we suggest that the screening of patients with skin sepsis over 40 years of age provides an opportunistic method of screening. This strategy should yield clinically significant numbers of abnormal cases.

Prevalence of diabetes mellitus in rural Saudi Arabia.

Several studies have clearly shown the impact of modernization on the prevalence of diabetes mellitus in susceptible communities. Saudi Arabia has faced a rapid development program over the last two decades. In a recent study, we found a high prevalence of diabetes mellitus in urban Saudi Arabia. A total of 5222 rural subjects of both sexes were involved in a study of the prevalence of diabetes mellitus in the western region of Saudi Arabia. Random capillary blood glucose, body weight and height, and income were recorded. The results showed an overall prevalence of 4.3%. There was a rise of prevalence with age and higher-income groups. Prevalence also differed with sex. The overall prevalence in women (5.9%) was twice that for men (2.9%; P less than .001). Obesity occurred in 41.2% of our diabetic subjects compared to 29.3% in nondiabetic subjects (P less than .001). Multiple logistic regression analysis with body mass index (BMI) as the dependent variable showed that sex and income status were significant factors (P less than .0001 and P less than .04, respectively). When blood glucose was fixed as the dependent variable, the analysis showed that age, income, and BMI were significant factors (P less than .004, P less than .0001, and P less than .045, respectively).

Effectiveness of mass screening for diabetes mellitus using random capillary blood glucose measurements.

The results of 23 228 finger-prick capillary blood glucose tests (the taking of which was coordinated by the Diabetic Association of New South Wales) were reviewed. All non-diabetic persons (n = 860) with a blood glucose result of greater than or equal to 8.0 mmol/L were surveyed and 459 responded (53.4%). The responders were typical of the surveyed group with respect to age and capillary blood glucose level. Sixty-four new cases of diabetes were detected, representing 15.8% of the replies from persons who were not known to have diabetes and 0.28% of the total number of persons screened.