Evaluation of the Three Glucometer Devices Performance in Comparison with the Cobas Integra 400 Plus Autoanalyzer in Measuring Blood Glucose Levels: A Comparative Cross-Sectional Study

Objective: The study aimed to evaluate the performance of the three glucometers compared to standard the laboratory method (Cobas Integra 400 Plus) in measuring blood glucose levels. Patients and Methods: A total of 100 Yemeni diabetic patients were randomly recruited into a comparative cross-sectional study. Venous and finger-pricked blood samples were obtained from all participants and used for blood glucose levels measurement following the standard procedures. Results: The mean blood glucose levels for one-hundred diabetic patients using the Gluco Contour TS and Gluco SD Codefree were not significantly different compared with the Cobas Integra 400 Plus (12.14 ± 6.89 mmol/L vs. 12.85 ± 8.83 mmol/L, P = 0.159;12.50 ± 7.18 mmol/L vs. 12.85 ± 8.83 mmol/L, P = 0.490), respectively. However, there is a significant difference using the Gluco Alert device from that of the Cobas Integra 400 Plus (11.83 ± 6.94 mmol/L vs. 12.85 ± 8.83 mmol/L, P = 0.046). Furthermore, using the ROC curve at a 95% confidence interval, the Cobas Integra 400 Plus showed a significant agreement with the Gluco Contour TS (51.4%), Gluco SD Codefree (50.4%), and Gluco Alert (39.3%), respectively. For determining accuracy, the sensitivity of the glucometer devices was the following: Gluco SD Codefree (87.3%), Contour TS (85.9%), and Gluco Alert (78.9%). In this regard, the highest specificity was related to Gluco Contour TS (65.5%). Conclusion: The correlation between both methods was good, with high sensitivity and specificity in measuring blood glucose levels as indicated by the ROC curve. Thus, we suggest using these glucometers at homes and hospitals as a point of care for diabetic patients.

Technology and Inequity in Health： The Geographical Distribution of Glucometers for the Control of Diabetes

Technological innovation plays an important role in the dynamics of economic growth and in promoting the welfare of the general population. In support of this hypothesis, an empirical study was carried out to assess the spatial distribution of insulin and supplies （glucometers） for the control of diabetes in patients registered in the Public Healthcare System in Salvador, Bahia, from 1998 to 2012. In order to achieve this objective, we applied a combination of data collection strategies, including spatial analysis and discrete choice model estimation. The study proposed to answer the following question： What factors affect access to the supplies required to control diabetes in insulin-dependent patients？ To this end, we assessed the spatial distribution of diabetic patients in Salvador who had received glucometers. The hypothesis asserted that social, economic and geographical factors determine access to the supplies （glucometers） used to control diabetes. Exploratory Spatial Data Analysis （ESDA） was therefore performed using the Global Spatial Autocorrelation Index in order to analyze the spatial distribution of glucometers. We then performed econometric estimations and analyzed the results. The final results initially demonstrated that there were major inconsistencies in the distribution of glucometers; i.e. purely random factors largely determined the probability of obtaining this device. Individual characteristics were not decisive factors in the probability of obtaining a glucometer, which were insteadrelated to type of diabetes and recommended treatment.

Self monitoring of blood glucose and its association with glycaemic control and lipid levels in type 2 diabetic patients aged 40 - 75 in Trinidad and Tobago

This study was done to assess whether self monitoring of blood glucose is associated with better glycaemic control in type 2 diabetic Trinidadians. Data was collected from 146 type 2 diabetics via interviews and medical files. Variables extracted included fasting blood glucose, HbA1c and lipid profile. Recent users of the glucometer had better glycemic control compared with longstanding users (HbA1c: 8.4% ± 0.28% vs 9.4% ± 0.62%). Diabetics using a glucometer for >11 years had the highest cholesterol (234 ± 27mg/dL) while those using it 6 months to 5 yrs had the lowest values (206 ± 8 mg/dL). Using the glucometer occasionally or once a week had little impact on these indices. Usage of insulin preparation was positively correlated with HbA1c (r = 0.295;p = 0.001) while those relying on oral hypoglycaemic agents showed a negative correlation (r = -0.265). Further, those who took their medication as prescribed had a lower HbA1c than those who took their medication occasionally. Ironically, HbA1c fell with increasing duration between clinic visits with those visiting annually having the lowest HbA1c (9.0% ± 0.2% vs 7.1% ± 0.7%). Compliance with lifestyle and exercise resulted in lower HbA1c and blood lipids. Poor client education on glucometer usage, administration of insulin and non-compliance with diet and exercise were associated with higher HbA1c.