Capillary Blood Glucose Screening (Accu-Chek Advantage) for Gestational Diabetes
Thanarat Srimaekarat MD*
Affiliation : * Department of Obstetrics and Gynecology, Trang Regional Hospital, Muang, Trang, Thailand
Objective : To determine optimal threshold of capillary blood glucose screening (Accu-Chek Advantage) for
gestational diabetes
Study design: A cross-sectional analytical study.
Material and Method: Capillary and venous blood of pregnant women who attended the antenatal clinic at
Trang Regional Hospital between August 2007 and May 2008 were collected for glucose testing (by approach
of American Diabetes Association’s Fourth International Workshop-Conference on Gestational Diabetes) at
one hour after taking 50 gm glucose. The glucose values of Accu-Check Advantage were compared with the
standard venous plasma glucose. The receiver operator characteristic (ROC) curve was created to determine
the optimal threshold of the capillary blood test screening for gestational diabetes.
Results : A total of 816 pregnant women were enrolled in the present study. Their capillary blood glucose
values and plasma glucose values were checked with the Accu-Chek Advantage and the central laboratory
chemistry analyzer, respectively. The good correlation between capillary blood glucose and plasma glucose
values was found (correlation coefficient = 0.80, 95% CI 0.77-0.82). There was a significant difference in the
average values of capillary blood and plasma blood (134.1 vs. 122.7 mg/dl, respectively). When the data were
analyzed by ROC curve, the optimal level of capillary blood by Accu-Chek Advantage for performing a 100 gm
oral glucose tolerance test was 140 mg/dl (reference plasma glucose level of at least140 mg/dl). The sensitivity,
specificity, likelihood ratio for a positive test result and likelihood ratio for a negative test result were 93.8%,
83.6%, 5.71 and 0.07, respectively. The potential advantages of capillary blood glucose screening are simple
to use, cheap and convenient.
Conclusion : Accu-Chek Advantage is suitable for screening gestational diabetes using the optimal threshold
capillary glucose level of 140 mg/dl
Keywords : Blood glucose, Diabetes, gestational, Mass screening
