International Journal of Diabetes Mellitus
Volume 2, Issue 1 , Pages 24-27, April 2010

Should capillary blood glucose measurements be used in population surveys?

  • R. Tirimacco

      Affiliations

    • Integrated Cardiovascular Clinical Network SA, Bedford Park, South Australia, Australia
    • Corresponding Author InformationCorresponding author. Address: iCCnet SA, Level 3B (Mail Box 28), Mark Oliphant Building, Laffer Drive, Bedford Park SA 5042, Australia. Tel.: +61 8 8201 7842, +61 412 749 418 (mobile); fax: +61 8 8201 7850.
    • ,
  • P.A. Tideman

      Affiliations

    • Integrated Cardiovascular Clinical Network SA, Bedford Park, South Australia, Australia
    • Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia
    • ,
  • J. Dunbar

      Affiliations

    • Greater Green Triangle, University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Australia
    • ,
  • P.A. Simpson

      Affiliations

    • Integrated Cardiovascular Clinical Network SA, Bedford Park, South Australia, Australia
    • ,
  • B. Philpot

      Affiliations

    • Greater Green Triangle, University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Australia
    • ,
  • T. Laatikainen

      Affiliations

    • Greater Green Triangle, University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Australia
    • National Institute for Health and Welfare, Helsinki, Finland
    • ,
  • E. Janus

      Affiliations

    • Greater Green Triangle, University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Australia
    • Department of Medicine, Western Health, Melbourne, Victoria, Australia

Received 1 September 2009; received in revised form 27 November 2009; accepted 5 December 2009. published online 07 January 2010.

Abstract 

Objective

To determine the accuracy and appropriateness of capillary blood glucose testing in population surveys.

Materials and methods

Capillary blood glucose using the Rochec ACCU-CHEK instrument and Advantage 11 Test Strips was compared to a laboratory instrument. Three independent cross-sectional risk factor surveys (n=1432) and baseline individuals from the Greater Green Triangle Diabetes Prevention Project (n=341) provided both fasting plasma and capillary blood glucose measurements. Accuracy of capillary glucoses was assessed using the ISO 15197 standard. The median age of the participants was 71years, ranging from 25 to 84years. There were 799 males and 974 females.

Results

Capillary glucose method had poorer precision at lower concentrations (CV: 9.50%, mean=3.09mmol/L, CV: 4.90%, mean=16.78mmol/L, n=233 replicates). Individual discrepancies were seen across the measuring range (2.8–19.9mmol/L, n=1773). In total, 94.5% of results fell within the minimum acceptable accuracy standards. This was slightly short of the 95% of results required to meet the ISO 15197 standard. The prevalence of diabetes in the study population using glucose ⩾7.0mmol/L was 2.4% (95%CI 1.8–3.3%) according to fasting plasma glucose and 2.8% (2.1–3.8%) according to fasting capillary glucose. The lower WHO-defined cut-off of 6.1mmol/L for capillary blood glucose testing gave a prevalence of 10.7% (9.0–12.5%).

Conclusions

This study of matched capillary and plasma glucose results concludes that while it is appropriate to use fasting capillary glucose levels to determine the prevalence of diabetes in populations, it should not be used to reliably diagnose diabetes in individuals.

Abbreviations: r, Bland Altman Pearson correlation coefficient, GGT, Greater Green Triangle, ISO, International Organisation for Standardisation, BMI, body mass index

Keywords: Capillary blood glucose, Type 2 diabetes, Population health, Risk factor surveys, Point-of-care testing

 

PII: S1877-5934(09)00059-9

doi:10.1016/j.ijdm.2009.12.002

International Journal of Diabetes Mellitus
Volume 2, Issue 1 , Pages 24-27, April 2010

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