The recently published NACB LMPG on DM discusses this issue to certain extent (although not in relation to OGTT), and does not recommend glucose meters for diagnosis or screening due to insufficient evidence and inappropriate analytical performance to support such a role for meters (http://www.aacc.org/members/nacb/LMPG/Pages/default.aspx).

 

However, if you look at the evidence table in this guideline on glucose meters for diagnosis and screening (p68) there is reference to WHO recommendations which endorse POCT for diagnosis and screening (particularly in countries where access to lab based testing is limited).

The ADA and NACB guideline group believe inaccuracy and imprecision of meters preclude their use for such purposes but these guidelines address audiences where appropriate lab-based testing is available.

Prof. Andrea Rita Horvath
Clinical Director
SEALS North, Department of Clinical Chemistry
Level 4, Campus Centre, Prince of Wales Hospital
Barker Street, Randwick, NSW 2031, Sydney, Australia
Tel: (+612)-9382 9078
Fax: (+612)-9382 9099
Mobile No: (+61)-404 027 843.

 

Avril,

 

We looked at this on an IFCC POCT committee and it is being revisited. Where there is a clearly abnormal glucose then OK and there is a move to HbA1c for screening too.

 

The IFCC committee were unconvinced that the imprecisons associated with POCT glucose meters was sufficiently tight to categorise IFG &/or IGT especially at the margins.

 

Unfortunately the NACB LMPG on POCT did not address the question you are asking, nor did the Australian GP POCT study. Consensus at the moment in don’t use meters to diagnose DM, but OK for screening.

 

Ian

 

 

 

Dear colleagues

As our GPs are being encouraged to undertake more and more oral glucose tolerance tests, more of them are doing the tests in the surgery (following the protocol provided by our laboratory). This morning I took a phone call from one GP who was interested in using POCT glucose meters to obtain the results rather than sending the samples to the laboratory.

 

Apart from the obvious facts of laboratory result vs POCT result, and the issues of capillary sampling, are there any other good reasons why POCT should not be used? Is anyone out there already doing this?

 

Kind regards

 

 

Avril

 

Avril Wayte

Consultant Biochemist

Clinical Chemistry

Ysbyty Gwynedd

Clinical Lead for Biochemistry, BCUHB

 

 

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