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Wiaam Al-Hasani

and 9 more

Objective: To assess the clinical utility of point of care (POC) capillary blood glucose (CBG) in the assessment of gestational diabetes (GDM) during oral glucose tolerance test (OGTT). Design: Prospective cohort study. Setting: Antenatal clinics at King’s Collage Hospital. Population: Women screening for GDM between March and June 2020. Methods: CBG was measured using POC-StatStrip® (Nova) and venous plasma glucose (VPG) was measured by Roche (Cobas 8000 c702) analyser. GDM was diagnosed based on NICE-2015 criteria. The two methods were compared statistically using Analyse-It (v 5.40.2) Main outcome measures: Diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) for POC-StatStrip® compared to reference laboratory method. Results: 230 women were included. The number and the percentage of women with glucose concentration above the GDM thresholds using POC-StatStrip® vs. Lab-VPG measurement was 15 (6.5%) vs. 8 (3.4%) at fasting and 105 (45%.6) vs. 72 (31.1%) at 2-hour respectively. Sensitivity and specificity for POC-StatStrip® were 88% and 97% at fasting and 97% and 79% at 2-hour respectively. However, the specificity and the NPV for POC-StatStrip® concentrations ≤5.0 mmol/L at fasting or <7.5mmol/L at 2-hour were 100% and the sensitivity and the PPV for concentration >9.5mmol/L at 2-hour was 100 %. Conclusion: In our cohort POC-CBG measurement cannot entirely replace laboratory method in OGTT, however, it can be used to rule out/rule in GDM when the glucose concentrations are ≤5.0mmol/L at fasting or <7.5/>9.5mmol/L at 2-hour. Funding: not applicable. Key Words: Gestational Diabetes Mellitus (GDM), point of care (POC).