Blood Glucose Screening Research Articles

Clinical management and knowledge of neonatal hypoglycaemia in Germany: A national survey of midwives and nurses.

Despite being a common metabolic condition, the detection and care of neonatal hypoglycaemia in Germany largely depends on the infant's health-care provider, rather than a national protocol. Therefore, this study aimed to evaluate midwives' and nurses' knowledge and management of neonatal hypoglycaemia and to determine the need for national guidelines. An anonymous online survey was developed and completed by 127 perinatal nurses and midwives. Descriptive statistics, Mann-Whitney-U, χ2 and Fisher's exact tests were used to summarise and analyse the results. In total, 82% of respondents indicated using guidelines but routine blood glucose screening for neonates at risk for hypoglycaemia was rarely reported (44%). A blood glucose concentration of 2.5 mmol/L (45 mg/dL) was considered the treatment threshold by 52% of the respondents. However, the responses to clinical scenarios showed distinct differences regarding the management of neonatal hypoglycaemia. Finally, 49% of respondents reported insufficient knowledge regarding neonatal hypoglycaemia and 77% indicated that they would advocate the implication of enhanced national guidelines. There is considerable variation in knowledge about the prevention, screening and management of neonatal hypoglycaemia among nurses and midwives in Germany. Enhanced guidelines and education of health-care professionals are urgently needed to provide the best possible care to all hypoglycaemic newborns.

Assessment of the level of knowledge, awareness and management of hypertension and diabetes among adults in Imo and Kaduna states, Nigeria: a cross-sectional study

ObjectivesThis study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and...

Clinical profile of hypoglycemia in neonates admitted in neonatal intensive care unit of a tertiary care hospital

Background: This study was conducted to study the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU.Methods: All newborns admitted in NICU were examined and those with hypoglycemia (GMR<45 mg/dl) were included in the study and observed. In neonates with risk factors blood sugar was screened at 2, 6, 12, 24, 48 and 72 hours of life or whenever symptoms suggestive of hypoglycemia developed in any neonates and for critically sick neonates blood sugar was screened in every 6 hour in active phase of illness. Any neonates with blood glucose level less than 45 mg/dl were analysed for maternal risk factors, neonatal risk factors and course in the NICU.Results: The prevalence of neonatal hypoglycemia was 14.9% among NICU admissions. The maternal risk factors were GDM, PIH, and PROM. The neonatal risk factors were prematurity, SGA, LGA and comorbid conditions which include perinatal asphyxia, sepsis, polycythemia, shock. The common symptoms were poor feeding, lethargy, jitteriness, convulsions, irritability, hypotonia and cyanosis. Majority of the neonates required only oral feeds for correction of hypoglycemia.Conclusions: Blood glucose screening in neonates with this risk factor is mandatory as many of the neonates were asymptomatic. The importance of early initiation of breast feeding to prevent hypoglycemia should be emphasized.

Noninvasive blood glucose monitor via multi-sensor fusion and its clinical evaluation

Blood glucose monitoring is vital for controlling the complications of diabetes. We propose a noninvasive blood glucose monitor featuring multi-sensor fusion, which functions well for rapid yet accurate blood glucose monitoring and screening of diabetes. The characteristic parameters of diabetics were extracted by applying one-factor analysis of variance, and a classification model was established via principal components analysis and discriminant analysis to identify whether the subjects suffer from diabetes. In light of the challenges for noninvasive blood glucose monitoring modelling brought by different pathogeneses, disease processes and complicated complications of different diabetics, the subjects were classified into different categories via unsupervised K-means clustering algorithm and modelled for each category separately for expanded coverage and improved accuracy. The accuracy was clinically evaluated in 254 volunteers with type II diabetes. The results in the Parkes error grid were as follows: 58.33% in Zone A, 39.43% in Zone B and 2.24% in Zone C, with a correlation coefficient of 0.69 and a root mean squared error of 2.67 mmol/L. In 2019, the monitor was certified by the National Medical Products Administration of China as the first Class III Medical Device.

The Effects of Hyperemesis Gravidarum on the Oral Glucose Tolerance Test Values and Gestational Diabetes.

This study is aimed at determination whether pregnant women who develop hyperemesis gravidarum in the first trimester have a tendency to develop gestational diabetes mellitus (GDM). It is also aimed at identification of effects of hyperemesis gravidarum and GDM on prenatal and neonatal status in case they were detected together. Hyperemesis gravidarum diagnose was based on the following signs and symptoms. To diagnose GDM, first trimester fasting blood glucose measurement and subsequent blood glucose monitoring and 75-g oral glucose tolerance test (OGTT) were performed in the second trimester. A total of 949 singleton pregnant women (95 with and 852 without hyperemesis gravidarum) who met our criteria were included in the study. In the first trimester, plasma blood glucose and positive GDM screening were found to be significantly higher in the hyperemesis gravidarum group compared to the control group (p=0.042 and p<0.001, respectively). However, actual GDM cases were similar between both groups. The positive predictive value was significantly lower in the hyperemesis gravidarum group (28.5% vs. 72.7%, p=0.003). In the second trimester, the prevalence of GDM was 6.6% in the hyperemesis gravidarum group and 7.3% in the control group, with no significant difference (p=0.218) between-groups. In this study, hyperemesis gravidarum was found to cause changes in maternal metabolism in the first trimester of pregnancy due to limited calorie intake and fasting; in the presence of hyperemesis gravidarum, it should be known that the positive predictive value of first trimester gestational diabetes screening may decrease and the diagnosis of pseudo-GDM may increase.

ADA Diabetes Risk Test Adaptation in Indonesian Adult Populations: Can It Replace Random Blood Glucose Screening Test?

AimsThe use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for screening hyperglycemia in Indonesian population.MethodsThis cross-sectional study conducted at primary health care in Cibeber sub district at Cilegon city, Banten province, Indonesia. Subjects were aged ≥45 years old without a prior diagnosis of diabetes were recruited consecutively. The risk of hyperglycemia was measured using the ADA Diabetes Risk Test. Random capillary blood glucose (RcBG) with a cut-off value >140 mg/dL used as a comparison.ResultsFrom a total of 134 subjects, 23.13% of subjects (n = 31) had hyperglycemia. The ADA Diabetes Risk Test gave an area under the ROC curve (AUC) of 0.71 (95% CI: 0.60-0.81) with an optimal cut-off of value ≥5. The sensitivity of the ADA diabetes risk test in diagnosing hyperglycemia was 68% with a false-negative rate (FNR) of 32.26%. Meanwhile, at a cut-off value ≥4, the sensitivity of the ADA Diabetes Risk Test was 93% with an FNR of 9.7%.ConclusionADA diabetes risk test provides a valuable result as a diabetes screening tool in the Indonesian population, thus promotes intervention strategies for population known to be at risk

Pattern of Dysglycaemia and Family Risk Factors for Diabetes Mellitus among Patients Attending General Outpatient Clinic of Federal Teaching Hospital Ido-Ekiti, Ekiti State, Nigeria

Diabetes mellitus is a non-communicable disease that currently affects over 366 million people worldwide and its prevalence is likely to double by 2030. Therefore, the need to screen for diabetes mellitus has become an impetus. The objective of the study was to determine the prevalence of dysglycaemia and significance of familiar risk factors for diabetes mellitus among the study population.
 One hundred and thirty-two and 48 consecutive non-previously diagnosed DM and previously diagnosed DM patients respectively were recruited from the same clinic. An interviewer administered questionnaire was applied and blood samples were taken for blood glucose. The prevalence of dysglycaemia was 36.2% and only 40.6% of the diabetic patients who did fasting blood glucose had glycaemic control. Family history of Diabetes mellitus in the first generation was significantly associated with chance of developing diabetic mellitus in the study population.
 In conclusion, it is important physicians begin to be very proactive in the screening for blood glucose in order to detect them early and forestall complications that are associated with late diagnosis of diabetes mellitus.

Evaluation of the Participation of Community Pharmacists in Primary Healthcare Services in Nigeria: A Mixed-Method Survey.

Background: Achieving universal health coverage in poorly-resourced settings like Nigeria demands optimal mobilization of all healthcare resources including community pharmacists. Such efforts are hampered by insufficient data on primary healthcare (PHC) contributions by community pharmacists. The study aimed to identify PHC services offered by community pharmacists; assess impact of technologies on PHC service quality; and evaluate factors influencing management of PHC services in Nigeria.Methods: A descriptive cross-sectional survey of 321 community pharmacies and 642 clients was undertaken between April and August, 2019. Semi-structured pre-tested questionnaires were administered on randomly-selected community pharmacists and clients. Interviews were conducted with key informants. Data were summarized using frequency and percentages while weighted averages on 5-point ordinal scales and chi-square tests were used to identify weights and associations between variables respectively at P<.050.Results: Response rates of pharmacists and clients were 74.7% (N=321) and 100% (N=642); while their median ages were 39.41 and 51.20 years respectively. Community pharmacists offered services in all eight domains of PHC, especially supply of medicines for treating of endemic diseases (mean weighted average [MWA]=4.59), and disease prevention (4.54) but least of vaccine administration (2.39). Blood glucose screening devices were the most adopted technology with significant impact on service quality (χ2 6.86, P=.030). Major challenges to management of PHC services were poor awareness of pharmacists’ roles (4.31) and lack of integration with the PHC infrastructure (4.31). Capacity constraints in finances (4.11), technologies (4.09), and human resources (3.99) were significant. However, major facilitators were pharmacists’ managerial skills (4.35), and strong client relationships (4.27). Conclusion: In Nigeria, community pharmacists offered important PHC services. Deploying technologies were associated with improved service quality. If community pharmacists are integrated in the national PHC architecture and financial incentives are provided, their competences and goodwill would enhance the achievement of universal health coverage.

Intersecting gender inequalities in non-communicable disease risk factors in Kerala: A primary study

Abstract Evidence globally and in India indicates intersecting gender inequalities in Non-Communicable Diseases (NCDs) risk factors. These are understudied in Kerala, which is at an advanced stage of an epidemiological transition. We estimated sex differences in self-reported prevalence and screening coverage of blood pressure (BP) and blood glucose (BG) grouped by the socio-economic status. A multistage cluster random sampling survey of 3398 women and 2982 men was conducted in 4 districts of Kerala from July to October 2019. Descriptive, Relative Concentration Index (RCI) for age, wealth and education and Population Attributed Fraction (PAF) for caste/tribal groups and religion were computed using Stata 12 and WHO's Health Equity Assessment Toolkit (HEAT) Plus. More women reported BP and BG screening than men (BP - W: 90.3%; 95%CI: (89.1, 91.4) vs M: 80.8%; 95%CI: (78.5, 82.9); BG- W: 86.2%; 95%CI: 84.9, 87.4 vs M: 78.3%; (95%CI: 75.9, 80.6)).BP prevalence was significantly higher among women than men (BP - W: 11.2%; 95%CI: (9.0, 13.9) vs M: 7.9%; 95%CI: (6.6, 9.6). BP screening was concentrated among less educated women (WRCI: -0.2: 95%CI: -0.2, -0.1), older (WRCI: 0.3: 95%CI: 0.2, 0.4; MRCI: 0.5: 95%CI: 0.4,0.7) and wealthier populations (WRCI: 0.1: 95%CI: 0.03, 0.2; MRCI: 0.3: 95%CI: 0.1, 0.4).High BP was concentrated among more educated women (WRCI: 0.9: 95%CI: 0.1, 1.6) and less educated men (MRCI: -1.6: 95%CI: -2.6, -0.6). High BG was concentrated among less educated women (WRCI: -1.6: 95%CI: -2.4, -0.8) and more educated men (MRCI: 0.9: 95%CI: -0.1, -1.6). Religion inequality in high BG among women was -19.1(95%CI:-28.0, -10.2).We found distinct patterns of sex related inequalities in NCD risk factors in Kerala. There is a need for greater screening among men but also sub populations of women who may be under-served by screening services. These patterns require further exploration to understand contexts and pathways to ensure program design leaves no one behind. Key messages Intersecting gender inequalities in prevalence and screening coverage of NCD risk factors in Kerala, India. NCD screening should reach all gender equitably despite of their social economic status.

Providing Health Physicals and/or Health Monitoring Services in Mental Health Clinics: Impact on Laboratory Screening and Monitoring for High Risk Populations.

Providing physical health care in specialty mental health clinics is a promising approach to improving the health status of adults with serious mental illness, but most programs examined in prior studies are not financially sustainable. This study assessed the impact on quality of care of a low-cost program implemented in New York State that allowed mental health clinics to be reimbursed by Medicaid for provision of health monitoring and health physicals (HM/HP). Medicaid claims data were analyzed with generalized linear multilevel models to examine change over time in quality of physical health care associated with HM/HP services. Recipients of HM/HP services were compared to control clinic patients [Per protocol (PP)] and with non-recipients of HM/HP services from both intervention and control clinics [As-Treated (AT)]. HM/HP clinic patients, regardless of receipt of HM/HP services, were compared with control clinic patients [Intent-to-Treat (ITT)]. Analyses were conducted with adjustment for patient demographic and clinical characteristics and prior year service use. The PP and AT analyses found significant improvement in measure of blood glucose screening for patients on antipsychotic medication and HbA1C testing for patients with diabetes (AOR range 1.26-1.33) and the AT analysis found significant improvement in cholesterol screening for patients on antipsychotic medication (AOR 1.24). However, ITT analysis found no significant changes in quality of care in HM/HP clinic caseloads relative to control clinics. The low-cost HM/HP program has the potential to benefit patients who receive supported services, but its impact is limited by remaining barriers to service implementation.

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID-19.

AimTo evaluate the association between different degrees of hyperglycaemia and the risk of all‐cause mortality among hospitalized patients with COVID‐19.Materials and MethodsIn a retrospective study conducted from 22 January to 17 March 2020, 453 patients were admitted to Union Hospital in Wuhan, China, with laboratory‐confirmed severe acute respiratory syndrome coronavirus 2 infection. Patients were classified into four categories: normal glucose, hyperglycaemia (fasting glucose 5.6‐6.9 mmol/L and/or HbA1c 5.7%‐6.4%), newly diagnosed diabetes (fasting glucose ≥7 mmol/L and/or HbA1c ≥6.5%) and known diabetes. The major outcomes included in‐hospital mortality, intensive care unit (ICU) admission and invasive mechanical ventilation (IMV).ResultsPatients with newly diagnosed diabetes constituted the highest percentage to be admitted to the ICU (11.7%) and require IMV (11.7%), followed by patients with known diabetes (4.1%; 9.2%) and patients with hyperglycaemia (6.2%; 4.7%), compared with patients with normal glucose (1.5%; 2.3%), respectively. The multivariable‐adjusted hazard ratios of mortality among COVID‐19 patients with normal glucose, hyperglycaemia, newly diagnosed diabetes and known diabetes were 1.00, 3.29 (95% confidence interval [CI] 0.65‐16.6), 9.42 (95% CI 2.18‐40.7) and 4.63 (95% CI 1.02‐21.0), respectively.ConclusionWe showed that COVID‐19 patients with newly diagnosed diabetes had the highest risk of all‐cause mortality compared with COVID‐19 patients with known diabetes, hyperglycaemia and normal glucose. Patients with COVID‐19 need to be kept under surveillance for blood glucose screening.

Factors influencing postpartum blood glucose screening among women with prior gestational diabetes mellitus in a rural community.

The aims of the present study were: a) to investigate the current state of postpartum glucose screening in rural China; and b) to explore the factors influencing postpartum blood glucose screening among women with prior GDM based on Andersen's behavioural model of health service use. A multisite, cross-sectional study design, conducted from November 2017 to January 2018. A total of 465 women with prior GDM were included from two county-level hospitals in rural China. The potential influencing factors for postpartum blood glucose screening based on Andersen's behavioural model, including predisposing, enabling, and need factors, were collected by self-reported questionnaires. Chi-square tests and logistic regression were used to explore the influence of these factors on whether screening of blood glucose level after delivery occurred. The mean age of the women was 31.92years old (SD 5.16) and the mean time after delivery was 16.73months (SD 15.07). The postpartum glucose screening proportion was 32.7%. Women who did not have a full-time job (p= .011) (predisposing factor), had not received any treatment for GDM (p= .002), and were not informed about screening plans for diabetes by health professionals (p < .001) (enabling factor) were less likely to engage in postpartum glucose screening. The need factor, high actual risk of developing type 2 diabetes mellitus (T2DM), was not associated with postpartum blood glucose screening (p> .05). In rural China, most women with prior GDM were not screened for T2DM after delivery. The women with prior GDM who did not have a full-time job or had not received any prior treatment for GDM should be the target population for health education on postpartum glucose screening. There is a need for data on postpartum blood glucose testing rates among rural women. Future interventions aimed at increasing postpartum blood glucose screening are needed.

Software module development for non-invasive blood glucose measurement using an ultra-wide band and machine learning

Diabetes is a chronic disease and in uprising trend worldwide. There is no remedy, hence, blood glucose management is essential by screening blood glucose concentration levels (BGCL) regularly to maintain a healthy life. However, the present way of measuring BGCL is invasive by using a glucometer and drawing a blood sample directly from the human body. To overcome this discomfort-problem, a non-invasive device to measure BGCL is in demand. This paper presents an autonomous software module with a user-friendly graphical user interface (GUI) based on digital signal processing (DSP) and artificial neural network (ANN) to process, classify and recognize the BGL signature from captured ultra-wideband (UWB) signal through human blood medium. To capture the signal, a pair of UWB bio-antenna is placed in between the human earlobe. Received signals are captured and processed through GUI and undergo signal processing, ANN training, testing, and validation. An interface is developed to integrate the hardware (UWB transceiver, bio-antenna, etc.) and the developed software module to make a system. The initial system showed a consistent result with reliability and demonstrated 90.6% accuracy to detect the BGCL. The detection accuracy is 9.6% improved compared to existing work. Besides, this proposed system is cost-effective, user-friendly and suitable to be used by both doctors and home users.

Neonatal hypoglycemia and the CPT1A P479L variant in term newborns: A retrospective cohort study of Inuit newborns from Kivalliq Nunavut.

Neonatal hypoglycemia (NH) in the first days of life can largely be prevented by recognizing those at risk and managing accordingly. The CPT1A P479L variant is prevalent in northern Indigenous populations and is a possible risk factor for hypoglycemia. We report on NH incidence in the Kivalliq region of Nunavut, where all Inuit newborns are screened for NH. We reviewed clinical charts of 728 Inuit newborns from Kivalliq (January 1, 2010 to December 31, 2013) for blood glucose (BG) levels and infant/maternal characteristics, linking to CPT1A genotype; 616 newborns had BG data from 2 to 48 hours of life. NH was defined using Canadian Paediatric Society guidelines (≤2.0 mmol/L at 2 hours, <2.6 mmol/L at 2 to 48 hours). NH was documented in 21.4% overall, 24.4% of at-risk newborns and 19.5% of term newborns with no risk factors (≥37 weeks gestation, term-NRF). NH was documented in 22.0% of CPT1A P479L homozygous, 19.8% of P479L heterozygous and 4.8% of noncarrier term-NRF newborns. With multivariable logistic regression, the adjusted ORs for developing NH in term-NRF newborns was 4.97 for CPT1A P479L homozygotes (95% confidence interval [CI]:0.65-38.35, P=0.19) and 4.71 for P479L heterozygotes (95% CI:0.57-37.89, P=0.15). Term-NRF newborns had a higher NH incidence than previously reported, similar to that for at-risk newborns, possibly due to the CPT1A P479L variant. Since only Inuit newborns from Kivalliq are screened for NH, further study of long-term outcomes of NH in this population and the role of the P479L variant are warranted to determine if neonatal BG screening is indicated in all Inuit newborns.

Ratiometric fluorescent probe based on AuNCs induced AIE for quantification and visual sensing of glucose

Blood glucose measurement plays a very important role in clinical diagnosis and fluorescence analysis has attracted extensive attention. A novel ratiometric fluorescent system with aggregation induced emission (AIE) property for the detection of glucose was established in this work. In this system, bovine serum albumin-stabilized Au nanoclusters (BSA-AuNCs) served both as the fluorescent detection probe and the AIE inducer. An AIE molecule, named sodium 1,2-bis [4-(3-sulfonatopropoxyl) phenyl]-1,2-diphenylethene (BSPOTPE), served as fluorescent reference probe. In the presence of H2O2, the fluorescence intensity of BSPOTPE/BSA-Au NCs at 680 nm progressively decreased while that at 490 nm remained constant. Glucose can be catalyzed by glucose oxidase (GOx) and produces H2O2. Therefore, glucose detection can be conveniently achieved by the proposed strategy. The fluorescence intensity change ratio increased linearly with the glucose concentration in the range 1–8 mM. Moreover, the proposed method exhibits a consecutive fluorescence color change (“from red to cyan”) to glucose concentration in the range of 1–8 mM under a 365 nm UV lamp and exhibits bright “red” or bright “cyan” in lower glucose concentrations (lower than 3 mM) or high glucose concentrations (higher than 7 mM), respectively. The work offers an ideal rapid clinical diagnostic method for both normal and abnormal blood glucose screening.

Hypoglycemia in Newborns with risk factors of hypoglycemia.

Objectives: Hypoglycemia is a matter of great concern especially in newborns. Its prevalence varies globally as different protocols and feeding policies exist. We aimed this study to find out the incidence of hypoglycemia in newborns with risk factors of hypoglycemia. Study Design: Observational study Setting: Pediatric Medicine Unit-2, Mayo Hospital, Lahore. Period: From 1st January 2018 to 31st December 2018. Material &amp; Methods: A total of 342 babies born with risk factors for hypoglycemia fulfilling the inclusion and exclusion criteria were considered for this study. Screening for hypoglycemia was performed prior to feeding at 2, 6, 12, 24 and 48 hours of life. Results: Out of a total of 342 newborns with risk factors, 109 (31.9%) were found to have hypoglycemia. Amongst these newborns, 99 (28.9%) and 10 (2.9%) newborns had asymptomatic and symptomatic hypoglycemia respectively. Among these 109 newborns, majority were male 56 (51.4%), 70 (64.2%) with gestational age more than 37 weeks, 66 (60.6%) with birth weight more than 2500 grams and 62 (56.9%) small for gestational age (SGA). Amongst newborns who developed at least 1 hypoglycemia episode, 52 (47.7%) were at 2 hours of life, 31 (28.4%) at 6 hours whereas no hypoglycemia episode recorded beyond 24 hours of life. Conclusions: Screening for hypoglycemia should always be performed in babies who had risk factors of hypoglycemia especially within 24 hours of life. As per our study blood glucose screening should be mandatory in all newborns who are SGA.

Risk Factors for Diabetic Retinopathy in Type 2 Diabetes Mellitus

Objectives: To find risk factors to diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) patients. Methods: A four years cross sectional study involving 386 patients with T2DM conducted at the diabetes clinic in Al-Hindeya General Hospital, Karbala, Iraq. Interviews were done for the participants focused on sociodemographic factors and included general examination with laboratory screening for fasting blood glucose (FBG), glycated haemoglobin (HbA1c), and serum lipids. The participants underwent ophthalmological testing including visual acuity, slit lamp examination, and optical coherence tomography. The patients were divided into retinopathy and non-retinopathy groups involving 109 and 277 patients, respectively. Both groups were screened for risk factors including age, gender, duration of disease, body mass index (BMI), treatment modality, HbA1c, and dyslipidemia. Results: The study included 109 patients (62 females, 47 males) with retinopathy and 277 patients (149 females, 128 males) control. Mean age for retinopathy and control groups were 54.76± 7.63 and 54.15± 9.20 years, respectively. Mean duration of disease for retinopathy and control groups were 12.79± 5.91 and 8.51± 5.16 years, respectively. Longer duration of disease and poor glycemic control showed positive association with DR with a P-value of 0.0001 and 0.033, respectively. Gender, BMI, age, treatment modality, and dyslipidemia showed negative association with DR. Conclusions: In our study DR significantly associated with longer duration of disease and poor glycemic control while the relation was insignificant for gender, BMI, age, treatment modality, and dyslipidemia. Keywords: Type 2 diabetes mellitus, Diabetic retinopathy, glycated hemoglobin, risk factor for retinopathy. DOI : 10.7176/JHMN/70-08 Publication date: January 31 st 2020

Oral glucose tolerance test: unnecessary requests and suitable conditions for the test

ABSTRACT Introduction: The oral glucose tolerance test (OGTT) is an important test for diagnosis of diabetes mellitus (DM) that needs criteria to be requested and analytical performance evaluation. Objectives: Determine the prevalence of unnecessary OGTT requests and analyze patients’ suitability criteria for glucose load. Method: Cross-sectional, descriptive and analytical study conducted with 554 patients who had OGTT requested from January to April 2018. Data from laboratory tests were collected through Complab Advanced version 6.9.6 system, organized into a Microsoft® Excel table and analyzed using Epi InfoTM, version 7.2.1.0. The accuracy of the glucometer paired analysis was performed by determinations of Student’s t test, using SPSS version of IBM 21TM. Patients with a previous diagnosis of DM and/or who showed OGTT request as a screening test along with blood glucose or glycated hemoglobin were classified as unnecessary requests. Results: Among the studied patients, 17% (94) had unnecessary OGTT requests, 53 (53.4%) patients had blood glucose ≥ 140 mg/dl and previous DM and/or OGTT used as screening; 41 (43.6 %) patients with capillary blood glucose < 140 mg/dl, but with a diagnosis of DM. The glucometer proved to be accurate with a high correlation (r 2 = 0.97, p < 0.0001) with serum glucose. Approaches during screening and capillary blood glucose prevented unnecessary exposure to glucose overload in 67% (63) of the patients. Conclusion: The high prevalence of unnecessary OGTT requests underscores the need of criteria for OGTT requesting and the standardization of procedures for screening in the exam.

A Retrospective Multicenter Study on the Usefulness of 50 g Glucose Challenge Test in Gestational Diabetes Mellitus Screening.

Introduction: To clarify the usefulness of glucose challenge test (GCT), the rate of gestational diabetes mellitus (GDM) detection and perinatal outcomes were compared between the groups of random blood glucose level (RBG) and 50 g GCT in this study. Methods: The first survey was conducted at 255 institutions registered by the Kanto Society of Obstetrics and Gynecology and clinical training institutions in the Kanto Area, followed by a second survey. The included women were broadly classified into the RBG and GCT groups, according to the mid-trimester blood glucose screening method, and the perinatal outcomes of the two groups were retrospectively compared. The primary outcomes were the proportion of infants weighing 3,500 g or more and birth weight ≥90th-percentile infants. Results: The rate of GDM diagnosis was significantly higher in the GCT group (7.6%) than that in the RBG group (4.8%). However, no significant differences were observed in perinatal outcomes, i.e., the proportion of infants weighing 3,500 g or more or birth weight ≥90th percentile. Conclusions: GCT is not superior for predicting infants weighing 3,500 g or more and birth weight ≥90th percentile, as compared with RBG.

Should screening voluntary blood donors be used as strategy to diagnose diabetes and diabetic nephropathy?

Introduction and Aim:The present study aims to assess the glycemic status during voluntary blood donation as a strategy to detect undiagnosed diabetes mellitus and diabetic nephropathy.Material and Method:Study was conducted at a tertiary care hospital and medical college. All voluntary blood donors underwent random capillary blood glucose screening and patients who had random blood sugar exceeding 200 mg/dl were subjected to undergo oral glucose tolerance test (OGTT). The subjects thus detected diabetic by capillary blood sugar and OGTT underwent screening diabetic kidney disease with urine albumin to creatnine ratio (UACR). Data collected was statistically analyzed using SPSS 16 using Student's t test.Results:Seven hundred and sixty five males and 443 females were enrolled for the study. Capillary blood sugar of 54 subjects was ≥200 mg/dl. 48 subjects gave consent for OGTT, stratified data showed 22 subjects (12 males and 10 females) were in range of 200–300 mg/dl. 20 subjects (12 males and 8 females) were in range of 300–400 mg/dl, whereas 6 subjects (5 males and 1 female) had blood sugar more than 400 mg/dl. The HbA1C ranges in respective glycemic groups were 200–300 mg/dl – 7.4% to 8.6% (mean – 8.05%), 300–400 mg/dl – 8.7% to 11.8% (mean 9.63%), more than 400 mg/dl – 11.8% to 14.2% (mean – 13%). Male preponderance was observed in all glycemic groups, though the difference was statistically insignificant. Of the 48 diabetic subjects, 13 (27.08%) were detected to have albuminuria, of these 11 (22.91%) had microalbuminuria (UACR 30 – 300 mg/gm), whereas 2 (4.16%) had overt proteinuria (UACR exceeding 300 mg/gm).Conclusion:Glycemic screening with random capillary blood glucose screening, 75 gm 2 hour OGTT and HbA1C amongst voluntary blood donors can be used to detect pre diabetes and undiagnosed diabetes mellitus and diabetic nephropathy.