Evaluating the validity of a bedside method of detecting hypoglycemia in children.

Background: Hypoglycemia in the pediatric age group is a common finding associated with a wide variety of disorders. It often presents urgent diagnostic and therapeutic challenges. In the tropics where facilities for laboratory evaluation are inadequate and inefficient, there is need to evaluate alternative methods of diagnosis.

Aims And Objectives: The aim of the study was to validate the glucometer method of assessing hypoglycemia in pediatric patients.

Methodology: Four hundred fifty-three consecutively admitted patients were recruited into the study. After a detailed history and thorough physical examination, 2 mL of blood was obtained from each patient. A drop was put on the test strip, and plasma glucose level read off a glucometer. The remainder was sent to the laboratory for comparative plasma glucose determination by the glucose oxidase method. Hypoglycemia was defined as plasma glucose less than 2.5 mmol/L (<45 mg/dL).

Results: Out of the 453 studied, only 392 (86.5%) had complete results and were included in the analysis. Thirty-eight (9.7%) were hypoglycemic by the glucometer method, but only 25 (6.4%) of them were hypoglycemic by the laboratory method. The glucometer was found to be highly sensitive and specific, and its results compares favorably with the laboratory values. The glucometer gave a predictive index of a positive test as 63.12% and of a negative test as 99.72%. It however leads to overdiagnosis of hypoglycemia.

Conclusions: The glucometer was found to be highly sensitive and specific, and its result correlates significantly well with the laboratory method. The glucometer method for blood sugar determination in emergency cases is highly recommended in children.