COMPARISION BETWEEN BED SIDE TESTING OF BLOOD GLUCOSE BY GLUCOMETER Vs CENTRALIZED TESTING IN A TERTIARY CARE HOSPITAL
Abstract
Background: To determine the accuracy, turnaround time and cost effectiveness of bedsidemonitoring of blood glucose levels by non-laboratory health care workers and centralized testing
of blood glucose by automated analyzer in a tertiary care hospital. Methods: The study was
conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and
Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi,
from April 2005 to March 2006.One hundred and ten patients were included in the study. The
blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using
Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical
laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. Results: We
observed good correlation between bed side glucometer and laboratory automated analyzer for
glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was
observed for glucose values less than 3.3 mmol/L (p=0.002) and glucose values more than 16.67
mmol/l (p= 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08
hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower
than centralized lab based testing. Conclusion: Bedside glucometer testing, though less expensive
does not have good accuracy in acutely ill patient with either very high or very low blood glucose
levels.
Key words: Bed side testing; Glucometer; Centralized glucose testing
References
Jacobs E, Vadasdi E, Sarkozi L, Colman N. Analytical
evaluation of i-STAT Portable Clinical Analyzer and use by
nonlaboratory health-care professionals.Clin Chem
;39(6):1069-74.
Friedman BA, Mitchell W. Integrating information from
decentralized laboratory testing sites. The creation of a valueadded network. Am J Clin Pathol 1993; 99:637-42.
Ellis Jacob. Point of care (near-patient) testing. Kaplan LA,
Pesce AJ, Kazmierezak SC.Clinical Chemistry 3rded: New
York: Mosby; 1996.p.313-22.
Nanji AA, Poon R, Hinberg I. Near-patient testing. Quality of
laboratory test results obtained by non-technical personnel in
a decentralized setting. Am J Clin Pathol 1998; 89(6):797-
Winkelman JW, Wybenga DR, Tanasijevic MJ. The fiscal
consequences of central vs distributed testing of glucose. Clin
Chem 1994; 40(8):1628-30.
Dillion AE, Menard MK, Rust P, Newman RB, VanDorsten
JP. Glucometer analysis of one-hour glucose challenge
samples. Am J Obstet Gynecol 1997; 177(5):1120-23.
Nosanchuk JS, Keefner R. Cost analysis of point-of-care
laboratory testing in a community hospital. Am J Clin Pathol
; 103(2):240-43.
Hamid MH, Chishti AL, Maqbool S. Clinical utility and
accuracy of a blood glucose meter for detection of neonatal
hypoglycemia.J Coll Physicians Surg Pak 2004; 14(4):225-28
Greendyke RM. Cost analysis. Bedside glucose testing. Am J
Clin Pathol1992; 97(1):106-7.
Trajanoski Z, Brunner GA, Gfrerer RJ, Wach P, Pieber TR.
Accuracy of home blood glucose meters during
hypoglycemia. Diabetes Care 1996; 19(12):1412-15.
Tang Z, Du X, Louie RF, Kost GJ. Effects of drugs on
glucose measurements with handheld glucose meters and
portable glucose analyzer. Am J Clin Pathol 2000; 113(1):75-
Sacks DB, Bruns DE, Goldstein DE, Maclaren NK,
McDonald JM, Parrott M. Guidelines and recommendations
for laboratory analysis in the diagnosis and management of
diabetes mellitus. Clin Chem 2002; 48(3):436-72.
Atkin SH, Dasmahapatra A, Jaker MA, Chorost MI, Reddy
S. Fingerstick glucose determination in shock. Ann Intern
Med 1991; 114(12):1020-24.
Nosanchuk JS, Salvatore JD. Improved pneumatic tube
system shortens stat turnaround time. Lab Med 1977; 8:21-
Nosanchuk JS, Stull R, Keefner R. The effect of substitution
of plasma for serum on chemistry turnaround time. Lab Med
; 22: 465-69.
Saxena S, Wong ET. Does the emergency department need a
dedicated stat laboratory? Continuous quality improvement
as a management tool for the clinical laboratory. Am J Clin
Pathol 1993; 100(6):606-10.
Zaloga GP, Hill TR, Strickland RA, Kennedy D, Visser M,
Ford K et al. Bed side blood gas and electrolyte monitoring
in critically ill patients. Crit Care Med 1989; 17(9): 920-25.
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