[Assessment of neonatal hypoglycemia with 2 test strip methods]

We evaluated two glucose test strips for their accuracy in detecting hypoglycemia in newborn infants. Reflotest-Hypoglycemia and Haemo-Glucotest and the reflectance meter technique Reflomat I and Reflolux II respectively were used for screening blood sugar values, and compared with laboratory glucose determination using an automatic analyzer (glucose oxidase method). In 134 neonatal blood samples of 56 newborn infants glucose was quantified with the three methods. Hypoglycemia was defined as blood glucose of less than 2.2 mmol/l (less than 40 mg/dl). Test sensitivity was 71%, specificity 97% for Reflomat I, 88% and 82% for Reflolux II, respectively. Analysing the falsely normoglycemic values measured by Reflomat I, no true blood sugar value below 2 mmol/l (less than 36 mg/dl) was found, and no value below 1.2 mmol/l (less than 22 mg/dl) measured by Reflolux II. Defining hypoglycemia as a blood glucose value of less than 2 mmol/l (less than 36 mg/dl) the sensitivity for Reflomat I would be 100%; therefore, significant hyoglycemia should not be missed with this test. Both tests give some false-positives; 3 of 100 Reflomat I and 18 of 100 Reflolux II readings were falsely below 2.2 mmol/l (less than 40 mg/dl). From these data we conclude that Reflomat I is an accurate screening-test for hypoglycemia in neonates; while the use of Reflolux II would cause too much unnecessary treatment.