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January 19, 2021

Contribution of Glucose Meter Error to Misclassification of Neonatal Glycemic Status

Author Affiliations
  • 1Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada
  • 2Division of Clinical Biochemistry, Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority, Saskatoon, Canada
JAMA Pediatr. 2021;175(5):453-455. doi:10.1001/jamapediatrics.2020.5787

Glucose point-of-care testing in the neonatal intensive care unit, as the basis for informing clinical decision-making and treatment of neonatal hypoglycemia, has been extensively adopted as a preferred clinical tool, given its ease of use and minimal blood volume requirement to obtain a timely bedside glucose result. National guidelines for the evaluation and management of neonatal hypoglycemia have become widely disseminated and incorporated into North American clinical practice.1-3 Inherent to these guidelines is the use of glucose meters, often with a caveat that glucose point-of-care testing devices are designed for hyperglycemia detection, whereas hypoglycemia detection and its error rates have never been prioritized and require clinical laboratory confirmation of glucose meter results. Given the convenience of glucose point-of-care testing, we surmise that, in many institutions, it has become the first-line clinical tool for neonatal glycemic decision-making.

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