Héctor Gallardo-Rincón, Julieta Lomelin-Gascon, Luis Alberto Martinez-Juarez, Alejandra Montoya, Janinne Ortega-Montiel, Victoria Galicia-Hernandez, Diego-Abelardo Álvarez-Hernández, Rosangela Ávila-Domínguez, Enrique Reyes-Muñoz, Lucía Marcela Illescas-Correa, Daniel Alberto Diaz Martinez, Francisco Javier Magos Vázquez, Edwin Oswaldo Vargas Ávila, Alejandro Efraín Benitez-Herrera, Diana Reyes-Gómez, María Concepción Carmona-Ramos, Laura Hernández-González, Oscar Romero-Islas, Ricardo Mújica-Rosales, and Roberto Tapia-Conyer
Héctor Gallardo-Rincón,1,2 Julieta Lomelin-Gascon,2 Luis Alberto Martinez-Juarez,2 Alejandra Montoya,2 Janinne Ortega-Montiel,2 Victoria Galicia-Hernandez,2 Diego-Abelardo Ãlvarez-Hernández,2 Rosangela Ãvila-DomÃnguez,2 Enrique Reyes-Muñoz,3 LucÃa Marcela Illescas-Correa,4 Daniel Alberto Diaz Martinez,5 Francisco Javier Magos Vázquez,5 Edwin Oswaldo Vargas Ãvila,5 Alejandro EfraÃn Benitez-Herrera,6 Diana Reyes-Gómez,6 MarÃa Concepción Carmona-Ramos,6 Laura Hernández-González,6 Oscar Romero-Islas,6 Ricardo Mújica-Rosales,2 Roberto Tapia-Conyer7 1University of Guadalajara, Health Sciences University Center, Guadalajara, Jalisco, Mexico; 2Carlos Slim Foundation, Mexico City, Mexico; 3Coordination of Gynecological and Perinatal Endocrinology, National Institute of Perinatology, Mexico City, Mexico; 4Maternal and Childhood Research Center (CIMIGEN), Mexico City, Mexico; 5Ministry of Health of the State of Guanajuato, Guanajuato, Mexico; 6Ministry of Health of the State of Hidalgo, Pachuca, Hidalgo, Mexico; 7National Autonomous University of Mexico, School of Medicine, Mexico City, MexicoCorrespondence: Luis Alberto Martinez-Juarez, Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Building (Floor 20), Miguel Hidalgo, Mexico City, 11529, Mexico, Tel +52 55 53 39 17 70, Fax +52 55 53 39 17 70, Email mjuarezl@fundacioncarlosslim.orgPurpose: Few pregnant women in low-resource settings are screened for gestational diabetes mellitus (GDM) using the gold standard oral glucose tolerance test (OGTT). This study compared capillary blood glucose testing with 2-h plasma glucose measurements obtained using the 75-g OGTT to screen for GDM at primary healthcare clinics in Mexico.Patients and Methods: Pregnant women who participated in a previous prospective multicenter longitudinal cohort study and who had not been previously diagnosed with diabetes were included. Participants were evaluated using the plasmatic 2-h 75-g OGTT with simultaneous capillary blood glucose measurements using a glucometer. The study endpoint was the comparability of the glucometer results to the gold standard OGTT when collected simultaneously. Sensitivity, specificity, and area under the curve of the glucose measurements obtained for capillary blood compared with venous plasma (gold standard) were calculated to determine diagnostic accuracy.Results: The study included 947 pregnant women who had simultaneous glucose measurements available (blood capillary [glucometer] and venous blood OGTT). Overall, capillary blood glucose testing was very sensitive (89.47%); the specificity was 66.58% and the area under the curve (95% confidence interval) was 0.78 (0.74â 0.81). The sensitivity, specificity and area under the curve of each capillary measurement were: 89.47%, 66.58% and 0.78 (0.74â 0.82) for the fasting measurement, 91.53%, 93.24% and 0.92 (0.88â 0.96) for the one-hour measurement, and 89.80%, 93.32%, 0.91 (0.87â 0.95) for the second-hour measurement, respectively. No adverse events were reported.Conclusion: Capillary OGTT is a valid alternative to the gold standard OGTT for screening of GDM in low-resource situations or in situations where there are other limitations to performing the OGTT as part of primary healthcare services.Keywords: capillary blood glucose, gestational diabetes mellitus, low-resource, Mexico, oral glucose tolerance test, screening