Each year millions of newborns—especially those born premature, underweight or sick—face the risk of neonatal hypoglycemia, a dangerous drop in blood sugar that can lead to seizures, brain injury and lifelong developmental problems if it is not identified and treated quickly. Early testing is therefore critical, but many hospitals worldwide lack access to reliable devices made for newborns.
A study led by researchers at the Rice360 Institute for Global Health Technologies and published in BMC Pediatrics evaluated 11 commonly available point-of-care glucometers. These small handheld meters are widely used by adults with diabetes; the team asked whether any low-cost, widely available models could be adapted safely for newborn care in low-resource settings.
Lead author Meaghan Bond and colleagues recreated neonatal blood conditions in the laboratory by modifying adult blood samples so they matched newborn glucose concentrations and hematocrit ranges, which differ from adults and can affect device performance. Each glucometer was compared with values from a clinical laboratory analyzer serving as the gold standard. This laboratory method let the team test accuracy and precision repeatedly at the glucose levels that matter most for babies without using large volumes of clinical samples from fragile newborns.
Devices were evaluated for performance at neonatal ranges and for consumable cost. Results showed that several low-cost glucometers provided reliable readings at neonatal hematocrit and glucose ranges; top performing low-cost devices included Accu-Chek Guide, GuideMe, Instant and Performa. Coauthor Rebecca Richards-Kortum said the findings give clinicians evidence-based choices where specialized neonatal meters are unaffordable, and that the testing approach can help other researchers evaluate new devices in the laboratory. The work supports the mission of NEST360 and involved pediatrician coauthors in Nigeria and Malawi. The study was supported through NEST360 with thanks to the Gates Foundation, ELMA Philanthropies, the Children’s Investment Fund Foundation, The Lemelson Foundation, Sall Family Foundation, and the Ting Tsung and Wei Fong Chao Foundation.
Difficult words
- neonatal — relating to newborn babies, especially first month
- hypoglycemia — dangerously low blood sugar level
- glucometer — small device that measures blood glucoseglucometers
- hematocrit — proportion of red blood cells in bloodhematocrit ranges
- precision — consistency of repeated measurements or results
- consumable — single-use item needed to operate a device
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What are the benefits and possible risks of adapting adult glucometers for newborn care in low-resource hospitals? Give reasons.
- How might the laboratory testing approach used in this study help other researchers or hospitals evaluate devices before clinical use?
- What practical barriers could prevent low-cost glucometers from being used widely for newborn testing in countries with limited resources?
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