The Accuracy of Capillary Whole Blood Glucose Versus Venous Plasma Glucose in the Diagnosis of Gestational Diabetes Mellitus in Egyptian Women

Objective: To check the accuracy of measuring Venous Plasma Glucose (VPG) and Capillary Glucose (CBG) in Gestational Diabetes (GD) among Egyptian women, adopting the standards of Diabetes in Pregnancy Study Group India (DIPSI).

Design: Prospective study.

Setting: Tanta University Hospital.

Methods: It was a prospective pilot study conducted on five hundred pregnant ladies with risk factors for glucose intolerance, and pregnant in second and third trimesters. Ladies recruited between May 2018 to May 2020. Seventy-five gram oral glucose was given, regardless of last meal; venous and capillary blood samples were collected at two. Correlation between VPG and CBG, sensitivity, specificity, and predictive values of either for abnormal glycemic profile (G.D. or D.M.) was assessed.

Result: The mean age of the participants was 24.89 ± 4.7 years, and also, the mean age (G.A.) was 25.77 ± 1.37 weeks. The mean BMI for the Normoglycemic group and, therefore, the diabetic group was 27.62 and 27.62, respectively. Only 55 of 500 cases were diagnosed as GDM in line with the DIPSI criteria, and 445 were Normoglycemic. The mean BMI for the Normoglycemic group and also the diabetic group was 27.62 and 27.62, respectively. We found a statistically significant direct correlation between CBG and VPG levels. The world under the curve by using the Receiver Operating Characteristic analysis was 0.995, which shows the high prediction power with 95% CI. The CBG cut point of 140 mg/dl provides the optimal sensitivity and specificity of 90.91% and 96.63%, respectively. The positive predictive value was 76.92%, and Negative predictive value was 98.85% at the same cut-off. There was an agreement between CBG and VPG where kappa value (K) is 0.803.

Conclusion: Measuring capillary blood sugar is an appropriate and cheap test for the diagnosis of gestational diabetes in developing countries.

Author(s): Ebtehal Mohsen Mahmoud Abu-Elkheir, Abd-ElGhaffar Saeid Dawood, Sahar Mohey Eldin Hazzaa*, Mohamed Nabih El-Gharib 

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