Study of blood sugar levels in high risk neonates using glucometer method and laboratory glucose oxidase peroxidase method


  • Yogesh P. Mehta Department of Pediatrics, Dr. L. H. Hiranandani Hospital, Mumbai, Maharashtra, India
  • Baliram P. Munde Department of Pediatrics, Dr. L. H. Hiranandani Hospital, Mumbai, Maharashtra, India



Accuracy, Capillary blood, Glucose estimation, Neonatal hypoglycemia


Background: The glucose oxidase method used for determining the blood glucose concentration is time consuming, requires more quantity of blood and rapid glycolysis of red blood cells glucose which mandates early estimation using faster techniques. A blood glucose method requiring one drop of blood and giving reliable results within a minute would help greatly in identifying and treating the infants who require extra carbohydrate. Glucometers have the advantage of being simpler, uses less quantity of blood, quick reading and can be handled even by unskilled personnel. Hence, there is a need to know the efficacy and accuracy of glucometer used in our set up.

Methods: About 150 infants admitted in NICU and high risk neonates in post-natal ward in department of pediatrics at our Hospital from June 2014 to June 2015 were included in the study. The blood samples were collected immediately after birth or within 5 minutes of admission. Comparison of variables representing categorical data (between two markers) were estimated by Chi Square Test. Sensitivity, Specificity and Predictive Values of Glucometer were calculated by using formulas. All values will be reported based on two-sided and all the statistical tests were interpreted at 5% level of significance level (i.e. p <0.05).

Results: After the comparison between glucometer and laboratory method, results show that blood glucose estimation using capillary blood has an excellent pick-up rate of detecting neonatal hypoglycemia. More than 93% of the proven cases of hypoglycemia proved by lab method] were diagnosed when blood glucose estimation with glucometer was done. The overall pick-up rate of hypoglycemia by glucometer is very good compared to the laboratory method.

Conclusions: Blood glucose estimation using Glucometer method is an effective method in detecting neonatal hypoglycemia.


Williams FP. Hypoglycemia in newborns: a review. BULL WHO. 1997;75:261-90.

Cornblath MP, Schwartz RS. Outcome of neonatal hypoglycemia Br Med J. 1999;318:194.

William WH, Tonse NK. Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: Workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development. J Pediatrics. 2009;155:612-17.

Mishra PK, Sharma BP. Hypoglycemia in Newborns-A Prospective Study. Ind pediatr. 1977;14:129-32.

Singhal PK, Singh MA, Paul VK, Deodari AK, Ghorpade MG, Malhotra A. Neonatal Hypoglycemia-Clinical profile and glucose requirements. Ind pediatr. 1992;29:167-71.

Dutta AK, Aggarwal AP. Neonatal Hypoglycemia-Controversies. Pediatr Tod. 2000;3:740-42.

Charles AS, Eugina KP. Disorders of Carbohydrate Metabolism. In: Avery Disease of the Newborn. Teuscch H.W., Ballard R.A. and Gleason C.A. 8th Ed. Philadelphia: Saunders; 2005:1410-1420.

Kleigman RM. Problems in Metabolic Adaptation: Glucose, Calcium and Magnesium. In: Care of the High-Risk Neonate. Klaus M.H. and Faranoff A.A. 5th ed. Philadelphia: Saunders; 2000:304-309.

Barbara JS, Robert MK. The Endocrine System. In: Nelson Text Book of Pediatr. Behrman R.E., Kliegman R.M., Jenson H.B. 17th ed. Philadelphia: Saunders; 2004:614-616.

Alkalay AL. Brain Imaging Findings in Neonatal Hypoglycemia: Case Report and Review of 23 Cases. Clinic Pediatr (Phila). 2005;44(9):783-90.

Threatte GA, Henry JB: Carbohydrates. In: Clinical Diagnosis and management by laboratory methods. JB Henry. 19th ed. Noida: Harcourt Asia PTE Ltd; 1999:194-207.

Hamid MH, Chishti AL, Maqbool SA. Clinical utility and accuracy of a blood glucose meter for the detection of neonatal hypoglycemia. J Col Physic Surg Pak. 2004;14(4):225-8.

Kalhan SC, Devaskar AU. Disorder of Carbohydrate Metabolism. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's, Neonatal Perinatal Medicine: Diseases of the Fetus and Infant. 9th Ed. St. Louis, MO: Mosby; 2010:1497-1520.

Ginsburg BE, Lindblad BS, Persson B, Zetters from R. Plasma valine and urinary C-peptide in infants. The effect of substituting breastfeeding with formula or formula with human milk Acta Pediatrica Scandinavica. 1985;74:615-6.

Hume R, Burchell A. Abnormal expression of glucose-6-phosphatase in preterm infants. Arch Dis Child. 1993;68(2):202-4.

Gupta RK. Care of low birth weight neonates. JK Science. 2008;10(4):158-9.

Harish JP, Srinivas HA, Soumya AP. Comparative Study of Glucometer and Laboratory Glucose Oxidase Method for The Estimation Of Blood Glucose Levels In Neonates. J Evol Med Dent Sci. 2015;4(16):2252-63.

Dahlberg MA, Ommundsen ES, Hovd AP, Whitelaw AD. Comparison of a new instant blood glucose method with conventional laboratory analysis in diagnosis of neonatal hypoglycemia. Pediatr Res. 1996;39(4):307.

Mehta NM, Whitelaw AS, Stone JT. Diagnosis of neonatal hypoglycemia at the cot side. A comparison of precision Q.I.D., Hemocue and Hexokinase Methods. Pediatr Res. 1999;45(94):211.

Ho HT, Yeung WK, Young BW. Evaluation of point of care devices in the measurment of low blood glucose in neonatal practice. Arch Dis Child Fetal Neanatal Ed. 2004; 89(4):F356-9.






Original Research Articles