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Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II.

ABSTRACT: Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.

SUBMITTER: Nevander S

PROVIDER: S-EPMC7760160 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II.

Nevander Sofia S Landberg Eva E Blomberg Marie M Ekman Bertil B Lilliecreutz Caroline C

Diagnostics (Basel, Switzerland) 20201126 12

Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous punctur ...[more]

PMID: 33255868

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Project description:BackgroundTo investigate the accuracy of screening tests for gestational diabetes mellitus (GDM) in Southeast Asian pregnant women.MethodsWe searched PubMed (MEDLINE), Web of Science, Cochrane Library, ClinicalTrials.gov, Google Scholar, and Google for relevant articles published in English up to November 2018 using search terms related to GDM, screening tests for GDM and diagnostic performance. The studies were independently screened and selected by both authors. The methodological quality of the included studies was independently assessed by quality assessment of diagnostic accuracy studies 2. A hierarchical summary receiver operating characteristic (HSROC) model was created to estimate the HSROC curve. The summary sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated in a meta-analysis using bivariate random-effects model.ResultsA total of 19 studies were included in which the 100 g oral glucose tolerance test (OGTT) and 75 g OGTT were the two common reference standards for diagnosis of GDM. Most points of diagnostic performance in the HSROC 50 g GCT curve compared with the 100 g OGTT reference standard were clustered in the upper left-hand quadrant. The pooled sensitivity and specificity of the 50 g GCT were 79% (95% confidence interval [CI] 64%-89%) and 74% (95% CI 59%-85%), respectively. For the 75 g OGTT reference standard, the non-fasting 2-hour plasma glucose showed quite similar sensitivity the 50 g GCT compared with the 100 g OGTT reference standard. The pooled sensitivities and specificities of the fasting plasma glucose and hemoglobin A1c were 81% (95% CI 76%-86%) and 70% (95% CI 67%-72%), and 80% (95% CI 66%-90%) and 69% (95% CI 58%-78%), respectively.ConclusionOur findings indicate that the 50 g GCT using the threshold of 140 mg/dL is a good screening test for identifying GDM at 24 to 28 weeks' gestational age for both high-risk and universal screening strategies in Southeast Asian countries. The non-fasting 2-hour PG, fasting plasma glucose or hemoglobin A1c are alternative choices for screening.

Dataset Information

Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II.

Publications

Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II.

Similar Datasets

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