PMID- 34952842
OWN - NLM
STAT- MEDLINE
DCOM- 20211230
LR  - 20220111
IS  - 2052-4897 (Electronic)
IS  - 2052-4897 (Linking)
VI  - 9
IP  - 2
DP  - 2021 Dec
TI  - Self-administered oral glucose tolerance test with capillary glucose measurements 
      for the screening of diabetes mellitus in high-risk adults: a feasibility study.
LID - 10.1136/bmjdrc-2021-002556 [doi]
LID - e002556
AB  - INTRODUCTION: Early diagnosis of prediabetes based on blood sampling for the oral 
      glucose tolerance test (OGTT) is crucial for intervention but multiple barriers 
      hinder its uptake. This study aimed to assess the feasibility and precision of a 
      self-administered capillary OGTT for type-2 diabetes mellitus (T2DM) in high-risk 
      individuals. RESEARCH DESIGN AND METHODS: Participants with history of 
      gestational diabetes or prediabetes were recruited in primary care. Due to their 
      prediabetic status and previous diagnosis of gestational diabetes mellitus, a 
      proportion of participants had previous experience doing OGTT. They 
      self-administered the capillary OGTT and concurrently their venous glucose 
      samples were obtained. They filled a questionnaire to collect their demographic 
      information, views of their capillary OGTT, and their preferred site of the test. 
      RESULTS: Among 30 participants enrolled in this feasibility study, 93.3% of them 
      felt confident of performing the capillary OGTT themselves, and 70.0% preferred 
      the test at home. Older, less educated participants found it less acceptable. 
      Mean capillary glucose values were significantly higher than venous glucose 
      values, with mean difference at 0.31 mmol/L (95% CI 0.13 to 0.49) at fasting, and 
      0.47 mmol/L (95% CI 0.12 to 0.92) 2 hours post-OGTT. Capillary and venous glucose 
      measurements were correlated for fasting (r=0.95; p<0.001) and 2-hour-post-OGTT 
      (r=0.95;p<0.001). The Fleiss-Kappa Score (0.79, p<0.0001) indicated fair 
      agreement between the two methods. The capillary OGTT had excellent sensitivity 
      (94.1%) and negative predictive value (NPV=91.7%) in identifying prediabetes or 
      T2DM status, vis-a-vis to venous glucose samples. CONCLUSION: Self-administered 
      capillary OGTT is feasible and acceptable, especially among younger adults, with 
      excellent sensitivity and NPV compared with plasma-based OGTT.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Tan, Andrew Yen Siong
AU  - Tan AYS
AUID- ORCID: 0000-0001-5438-6453
AD  - SingHealth Polyclinics, Singapore andrew.tan.y.s@singhealth.com.sg.
FAU - Tan, Mui Suan
AU  - Tan MS
AD  - SingHealth Polyclinics, Singapore.
AD  - Family Medicine Academic Clinical Program, SingHealth Duke-NUS Academic Medical 
      Centre, Singapore.
FAU - Wu, Ashley
AU  - Wu A
AD  - SingHealth Polyclinics, Singapore.
FAU - Seah, Ai Choo
AU  - Seah AC
AD  - SingHealth Polyclinics, Singapore.
FAU - Chong, Cecilia
AU  - Chong C
AD  - SingHealth Polyclinics, Singapore.
FAU - Koh, Eileen
AU  - Koh E
AD  - SingHealth Polyclinics, Singapore.
FAU - Tan, Ngiap Chuan
AU  - Tan NC
AD  - SingHealth Polyclinics, Singapore.
AD  - Family Medicine Academic Clinical Program, SingHealth Duke-NUS Academic Medical 
      Centre, Singapore.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - BMJ Open Diabetes Res Care
JT  - BMJ open diabetes research & care
JID - 101641391
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - *Diabetes, Gestational/diagnosis
MH  - Feasibility Studies
MH  - Female
MH  - Glucose Tolerance Test
MH  - Humans
MH  - *Prediabetic State/diagnosis
MH  - Pregnancy
PMC - PMC8710854
OTO - NOTNLM
OT  - community medicine
OT  - diabetes mellitus
OT  - oral glucose tolerance test
OT  - prediabetic state
OT  - type 2
COIS- Competing interests: None declared.
EDAT- 2021/12/26 06:00
MHDA- 2021/12/31 06:00
PMCR- 2021/12/24
CRDT- 2021/12/25 05:25
PHST- 2021/08/21 00:00 [received]
PHST- 2021/11/23 00:00 [accepted]
PHST- 2021/12/25 05:25 [entrez]
PHST- 2021/12/26 06:00 [pubmed]
PHST- 2021/12/31 06:00 [medline]
PHST- 2021/12/24 00:00 [pmc-release]
AID - 9/2/e002556 [pii]
AID - bmjdrc-2021-002556 [pii]
AID - 10.1136/bmjdrc-2021-002556 [doi]
PST - ppublish
SO  - BMJ Open Diabetes Res Care. 2021 Dec;9(2):e002556. doi: 
      10.1136/bmjdrc-2021-002556.