Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India.
Diabetes Technol Ther. 2012 Feb;14(2):131-4. doi: 10.1089/dia.2011.0060. Epub 2011 Oct 12.
Universal screening for gestational diabetes mellitus (GDM) is advocated in Indian women as they have the highest frequency of GDM among the South Asian population. For this the diagnostic procedure has to be simple, economical, and evidence based. Hence, this study was undertaken to compare point-of-care measured capillary whole blood glucose (CBG) with a glucometer and laboratory-estimated venous plasma glucose (VPG) and to suggest which is feasible as a diagnostic tool.
Consecutive pregnant women in the third trimester were included in this study with the approval of the institutional ethical committee. They were given 75 g of oral glucose in the fasting state. After 2 h, CBG was measured by finger prick using an Accu-Chek(®) glucometer (Roche Diagnostics India Pvt. Ltd., Mumbai, India), and venous blood was drawn to estimate VPG in the laboratory by the glucose oxidase-peroxidase method. The diagnosis of GDM was based on a 2-h plasma glucose level of ≥7.8 mmol/L (World Health Organization criteria).
Among 819 pregnant women, 86 (10.5%) were diagnosed as having GDM. The CBG value at a 2-h plasma glucose level of ≥7.8 mmol/L had a sensitivity of 80.2% and specificity of 98.5% with false-positive and false-negative rates of 1.5% and 19.8%, respectively. The area under the receiver operator characteristic curve of CBG was 0.991.
The CBG value at a 2-h plasma glucose level of ≥7.8 mmol/L may be recommended for the diagnosis of GDM in healthcare centers where laboratory technology is not available.
印度女性患有妊娠期糖尿病（GDM）的频率在南亚人群中最高，因此提倡对其进行普遍筛查。为此，诊断程序必须简单、经济且有证据支持。因此，本研究旨在比较即时检测毛细血管全血血糖（CBG）与血糖仪和实验室估算静脉血浆血糖（VPG），并提出哪种方法更可行作为诊断工具。
本研究经机构伦理委员会批准，纳入了处于妊娠晚期的连续孕妇。她们在空腹状态下给予 75g 口服葡萄糖。2 小时后，通过指尖采血用 Accu-Chek®血糖仪（罗氏诊断印度私人有限公司，印度孟买）测量 CBG，并抽取静脉血在实验室用葡萄糖氧化酶-过氧化物酶法测定 VPG。GDM 的诊断依据是 2 小时血浆血糖水平≥7.8mmol/L（世界卫生组织标准）。
在 819 名孕妇中，86 名（10.5%）被诊断为患有 GDM。2 小时血浆血糖水平≥7.8mmol/L 时的 CBG 值的敏感性为 80.2%，特异性为 98.5%，假阳性率和假阴性率分别为 1.5%和 19.8%。CBG 的受试者工作特征曲线下面积为 0.991。
在实验室技术不可用时，可推荐在医疗保健中心使用 2 小时血浆血糖水平≥7.8mmol/L 时的 CBG 值来诊断 GDM。
