A Case of Factitious Hyperglycemia in a Patient on Intravenous Ascorbic Acid

Sharma, Eliza; Resta, Christine; Park, Patricia

doi:10.1155/2018/7063137

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…In the study by Juan He et al, surprisingly significantly lower value was obtained for POC glucose as compared to LG values before hdVC infusion (158.08 ± 62.08 mg/dl vs 186.25 ± 71.50 mg/dl, P<0.001) or after hdVC treatment (142.90 ± 58.91 mg/dl vs 186.74 ± 72.74 mg/dl, P<0.001.This result is different from spurious higher values of POC glucose reported in the studies and case reports published so far (10,11,12). Juan He et al opine that the colorimetric method used in their study principally differs in mechanism from studies that used glucose dehydrogenase pyrroloquinoline quinine for POC glucose measurement (1).…”

Section: Accepted Manuscriptcontrasting

confidence: 72%

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Interaction between vitamin C and point of care glucose monitoring. are we overly wary of it or is it a valid concern?

Surani

Sharma²

2021

Current Medical Research and Opinion

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Section: Accepted Manuscriptcontrasting

confidence: 72%

“…Glucose and vitamin C have similar molecular structures with both bearing 6-carbon molecules. Oxidation of ascorbic acid by glucose oxidase and dehydrogenase generates electric current measured as glucose (11). Falsely elevated POC glucose can trigger an inappropriately aggressive treatment response leading to patient morbidity and mortality (10).…”

mentioning

confidence: 99%

Interaction between vitamin C and point of care glucose monitoring. are we overly wary of it or is it a valid concern?

Surani

Sharma²

2021

Current Medical Research and Opinion

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“…Based on similar studies, it was because of the role of reguler exercise to regulate BG level as its energy source for exercise and the improvement of muscle GLUT4 (glucose transpoter-4) expression that lead to an uptake more of blood glucose by cells [13]. Vasudevan and Hirsch [14] and Sharma et al [15] also found the BG elevation due to intravenous ascorbic acid. Yet, the other study by Dakhale et al [16] stated that ascorbic acid consumption reduced the BG level in diabetic patients.…”

Section: Bgmentioning

confidence: 99%

The Combination of Exercise and Ascorbic Acid Decrease Blood Glucose Level and Tend to Ameliorate Pancreatic Islets Area on High Carbohydrate Diet Rats

et al. 2019

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Objective: This study is conducted to determine the protective effects of physical exercise and ascorbic acid on increasing blood glucose (BG) levels and islet pancreatic area in high-carbohydrate (HC) diet rats. Methods: A total of 20 rats were divided into four groups: Control group which was a HC and treatment groups which were HC plus exercise (HCEx), HC plus ascorbic acid (HCAs), and HCEx and ascorbic acid (HCExAs). The duration of treatment was 9 weeks. Swimming to exercise held 6 times a week and ascorbic acid dose was 9 mg. Results: It showed that the smallest body weight was HCEx group. BG difference (before and after treatment = BG diff) had a significant difference (p=0.021) among groups, and the lowest level of BG diff was HCEx group. HCAs had the biggest BG diff. However, there was no significantly difference among groups on islet pancreatic area, but HC group had the largest area. Conclusion: This study suggests that a combination of exercise and ascorbic acid on HC diet subject may regulate BG level compared to the exercise or ascorbic acid alone. However, they do not influence pancreatic islet area.

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“…Amongst other factors, high concentration of ascorbic acid interfere with glucose readings from finger stick blood glucose (FSBG) meters [36]. A classic case of marked interference with FSBG readings is due to intravenous ascorbic acid, because the devices recognized ascorbic acid as glucose and erroneously detects hyperglycemia if ascorbic acid levels are high.…”

Section: (C) Incorrect Glucose Readingsmentioning

confidence: 99%

Dosing vitamin C in critically ill patients with special attention to renal replacement therapy: a narrative review

Honoré

Spapen

Marik

et al. 2020

Ann. Intensive Care

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Rationale/methods The primary aim of the present contribution is to find a literature-based agreement on dose adjustments of vitamin C in critically ill patients undergoing renal replacement therapy (RRT). Available data/study results Critical illness is frequently accompanied by severe vitamin C deficiency. High-dose supplementation beneficially affects clinical outcome in small cohorts of patients with sepsis, burn injury, and trauma. There are no specific data on clinical outcomes in patients receiving renal replacement therapy (RRT). Vitamin C plasma concentrations in patients on RRT are comparable to critically ill patients not receiving RRT. Vitamin C is cleared from the circulation during RRT at a rate dependent on the plasma concentration, dose and duration of RRT. Sieving coefficient is about 1. While the dose of RRT is lower than normal renal function, tubular reabsorption is absent. Sparse evidence suggests that vitamin C dosing during continuous RRT should not exceed the dose administered to critically ill patients not receiving continuous RRT. Low plasma concentrations are expected during prolonged RRT because of persistent extracorporeal removal, absent renal reabsorption and enhanced metabolic loss due to circuit-induced oxidative stress. A dosage of twice 1 g vitamin C daily may be necessary to achieve normal plasma concentrations during RRT, but more studies are needed. There is no available evidence that high doses of vitamin C administered over a short period can induce oxalate stones or has pro-oxidant effects. Conclusions Supplementing vitamin C 1 g twice daily to critically ill patients has a solid pathophysiological rationale and a good safety profile. Patients on RRT probably need similar doses as critically ill patients not receiving RRT. Intravenous vitamin C in a dose of 2 g/day may be necessary to achieve normal plasma concentrations during RRT. However, data on dose adjustment of vitamin C during intermittent or chronic RRT are sparse and require more thorough pharmacokinetic and dose–response studies.

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A Case of Factitious Hyperglycemia in a Patient on Intravenous Ascorbic Acid

Abstract: Finger stick blood glucose meters are widely used in outpatient and inpatient settings. However, various factors can affect accuracy of readings from these meters. Here we present a patient who had spurious glucose elevation on these meters while being on intravenous ascorbic acid.

Cited by 8 publications

References 18 publications

Interaction between vitamin C and point of care glucose monitoring. are we overly wary of it or is it a valid concern?

Interaction between vitamin C and point of care glucose monitoring. are we overly wary of it or is it a valid concern?

The Combination of Exercise and Ascorbic Acid Decrease Blood Glucose Level and Tend to Ameliorate Pancreatic Islets Area on High Carbohydrate Diet Rats

Dosing vitamin C in critically ill patients with special attention to renal replacement therapy: a narrative review

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