Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh

Objective To assess the effectiveness of random capillary blood glucose as a diagnostic tool for type 2 diabetes and determine optimal cut-off values for adults in Bangladesh.Design Cross-sectional diagnostic accuracy study.Setting 16 diabetes centres were selected randomly from all eight administra...

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Main Authors: Hajera Mahtab, Md Faruque Pathan, Md Robed Amin, Tasnima Siddiquee, Bishwajit Bhowmik, Sanjida Binte Munir, Shaila Parvin, Tareen Ahmed, Faria Afsana, Nazmul Kabir Qureshi, Ahmed Salam Mir, Rubayat Islam, Md Sarowar Uddin Milon, Rahat Iqbal Chowdhury, Rie Ozaki, Dulal Chandra Ray, Sumon Rahman Chowdhury, Sanjib Salah Aufi, Shamima Akhtar, Tamanna Afroz, Mohammad Abdus Samad, Abul Kalam Azad Khan
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/5/e093938.full
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author Hajera Mahtab
Md Faruque Pathan
Md Robed Amin
Tasnima Siddiquee
Bishwajit Bhowmik
Sanjida Binte Munir
Shaila Parvin
Tareen Ahmed
Faria Afsana
Nazmul Kabir Qureshi
Ahmed Salam Mir
Rubayat Islam
Md Sarowar Uddin Milon
Rahat Iqbal Chowdhury
Rie Ozaki
Dulal Chandra Ray
Sumon Rahman Chowdhury
Sanjib Salah Aufi
Shamima Akhtar
Tamanna Afroz
Mohammad Abdus Samad
Abul Kalam Azad Khan
author_facet Hajera Mahtab
Md Faruque Pathan
Md Robed Amin
Tasnima Siddiquee
Bishwajit Bhowmik
Sanjida Binte Munir
Shaila Parvin
Tareen Ahmed
Faria Afsana
Nazmul Kabir Qureshi
Ahmed Salam Mir
Rubayat Islam
Md Sarowar Uddin Milon
Rahat Iqbal Chowdhury
Rie Ozaki
Dulal Chandra Ray
Sumon Rahman Chowdhury
Sanjib Salah Aufi
Shamima Akhtar
Tamanna Afroz
Mohammad Abdus Samad
Abul Kalam Azad Khan
author_sort Hajera Mahtab
collection DOAJ
description Objective To assess the effectiveness of random capillary blood glucose as a diagnostic tool for type 2 diabetes and determine optimal cut-off values for adults in Bangladesh.Design Cross-sectional diagnostic accuracy study.Setting 16 diabetes centres were selected randomly from all eight administrative divisions of Bangladesh.Participants A total of 3200 adults aged 18 years and older were recruited using systematic random sampling between May and September 2022.Primary and secondary outcome measures The primary outcome was the diagnostic accuracy of random capillary blood glucose compared to fasting plasma glucose, 2-hour plasma glucose after a 75-gram glucose load and glycated haemoglobin. Secondary outcomes included sensitivity, specificity, area under the curve and agreement with the other diagnostic tests.Results Random capillary blood glucose showed a strong positive correlation and high concordance with fasting plasma glucose, 2-hour plasma glucose and glycated haemoglobin. A cut-off value of ≥8.7 mmol/L demonstrated improved diagnostic performance compared with the currently used cut-off of ≥11.1 mmol/L. This new threshold yielded higher sensitivity, specificity, area under the curve and agreement with other standard diagnostic tests. Notably, hyperglycaemic symptoms were not required for diagnosis. The number needed to screen to identify one case of type 2 diabetes using the ≥8.7 mmol/L cut-off was 2.74, lower than that for fasting plasma glucose (2.86) and random capillary blood glucose ≥11.1 mmol/L (4.68).Conclusions Random capillary blood glucose may be an effective and affordable diagnostic tool for type 2 diabetes in resource-limited settings. The proposed cut-off of ≥8.7 mmol/L offers improved diagnostic accuracy and reflects the population’s glucose distribution pattern.
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spelling doaj-art-65bd8f6f3b044d8cb5716061e5f018e72025-08-20T03:13:30ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-093938Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in BangladeshHajera Mahtab0Md Faruque Pathan1Md Robed Amin2Tasnima Siddiquee3Bishwajit Bhowmik4Sanjida Binte Munir5Shaila Parvin6Tareen Ahmed7Faria Afsana8Nazmul Kabir Qureshi9Ahmed Salam Mir10Rubayat Islam11Md Sarowar Uddin Milon12Rahat Iqbal Chowdhury13Rie Ozaki14Dulal Chandra Ray15Sumon Rahman Chowdhury16Sanjib Salah Aufi17Shamima Akhtar18Tamanna Afroz19Mohammad Abdus Samad20Abul Kalam Azad Khan211 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh2 Department of Endocrinology, BIRDEM, Dhaka, Bangladesh7 NCDC, DGHS, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh2 Department of Endocrinology, BIRDEM, Dhaka, Bangladesh3 Depart of Endocrinology, National Heallth Care Netwrok (NHN), Diabetic Association of Bangladesh, Dhaka, Bangladesh, Dhaka, Bangladesh4 BIHS, Dhaka, Bangladesh5 Department of Diabetology, NHN, Dhaka, Bangladesh6 Department of Endocrinology, BSMMU, Dhaka, Bangladesh7 NCDC, DGHS, Dhaka, Bangladesh8 JICA, Dhaka, Bangladesh9 DC Ray Diabetes Center, Dinajpur, Bangladesh10 BADAS, Chittagong, Bangladesh11 BADAS, Rajshahi, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh12 Depart of Endocrinology, National Heallth Care Netwrok (NHN), Diabetic Association of Bangladesh, Dhaka, Bangladesh1 Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, BangladeshObjective To assess the effectiveness of random capillary blood glucose as a diagnostic tool for type 2 diabetes and determine optimal cut-off values for adults in Bangladesh.Design Cross-sectional diagnostic accuracy study.Setting 16 diabetes centres were selected randomly from all eight administrative divisions of Bangladesh.Participants A total of 3200 adults aged 18 years and older were recruited using systematic random sampling between May and September 2022.Primary and secondary outcome measures The primary outcome was the diagnostic accuracy of random capillary blood glucose compared to fasting plasma glucose, 2-hour plasma glucose after a 75-gram glucose load and glycated haemoglobin. Secondary outcomes included sensitivity, specificity, area under the curve and agreement with the other diagnostic tests.Results Random capillary blood glucose showed a strong positive correlation and high concordance with fasting plasma glucose, 2-hour plasma glucose and glycated haemoglobin. A cut-off value of ≥8.7 mmol/L demonstrated improved diagnostic performance compared with the currently used cut-off of ≥11.1 mmol/L. This new threshold yielded higher sensitivity, specificity, area under the curve and agreement with other standard diagnostic tests. Notably, hyperglycaemic symptoms were not required for diagnosis. The number needed to screen to identify one case of type 2 diabetes using the ≥8.7 mmol/L cut-off was 2.74, lower than that for fasting plasma glucose (2.86) and random capillary blood glucose ≥11.1 mmol/L (4.68).Conclusions Random capillary blood glucose may be an effective and affordable diagnostic tool for type 2 diabetes in resource-limited settings. The proposed cut-off of ≥8.7 mmol/L offers improved diagnostic accuracy and reflects the population’s glucose distribution pattern.https://bmjopen.bmj.com/content/15/5/e093938.full
spellingShingle Hajera Mahtab
Md Faruque Pathan
Md Robed Amin
Tasnima Siddiquee
Bishwajit Bhowmik
Sanjida Binte Munir
Shaila Parvin
Tareen Ahmed
Faria Afsana
Nazmul Kabir Qureshi
Ahmed Salam Mir
Rubayat Islam
Md Sarowar Uddin Milon
Rahat Iqbal Chowdhury
Rie Ozaki
Dulal Chandra Ray
Sumon Rahman Chowdhury
Sanjib Salah Aufi
Shamima Akhtar
Tamanna Afroz
Mohammad Abdus Samad
Abul Kalam Azad Khan
Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh
BMJ Open
title Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh
title_full Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh
title_fullStr Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh
title_full_unstemmed Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh
title_short Random capillary blood glucose in the diagnosis of diabetes: a cross-sectional study in Bangladesh
title_sort random capillary blood glucose in the diagnosis of diabetes a cross sectional study in bangladesh
url https://bmjopen.bmj.com/content/15/5/e093938.full
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