Evaluation of the Impact of Hematocrit and Other Interference on the Accuracy of Hospital-Based Glucose Meters

Abstract

Correlation to plasma hexokinase values and hematocrit interference are the main variables that differentiate glucose meters. Meters that correlate with plasma glucose measured by a reference method over a wide range of glucose concentrations and minimize the effects of hematocrit will allow better glycemic control for critically ill patients.

Anemia in Critical Illness

“…However, there were no deaths among the small number of patients with levels of 7.1 to 8.0 g/dl. Anemia also leads to overestimation of serum glucose by point-of-care glucometers, creating a risk of hypoglycemia if these values are used to dose insulin (46). The subtle reversible cognitive dysfunction found during severe acute anemia in healthy subjects (47) is hypothesisgenerating regarding the relationship of anemia and delirium in the ICU.…”

Comparison of Point of Care (POC) Testing of Glucose by B Braun Glucometer and Hemocue Glucose 201+ Analyser Versus Centralised Testing in Neonatal Intensive Care Unit (NICU)

“…[Table/ Fig-1 It is believed that Hct levels affect glucose measurements by blood glucose [23,24]. In a recent study on premature neonates, accurate glucose results were provided at different Hcts using POC testing device [25].…”

Glucose Meter Performance Criteria for Tight Glycemic Control Estimated by Simulation Modeling

“…However, target glucose concentrations are narrower for this patient population than they are for patients using handheld meters to dose subcutaneous insulin. In addition, patients in the intensive care unit (ICU) 3 are on multiple medications and often have abnormal hematocrit and/or oxygen tension, all of which may affect the performance of handheld glucose meters (4,5 ).…”

“…Because hexokinase glucose methods have been found to be suitable for use as reference methods for glucose determination (6 ), multiple studies have examined the correlation between glucose meter whole blood and plasma hexokinase glucose. The degree to which glucose meters correlate with plasma hexokinase measurement of glucose varies between glucose meter technologies (4 ), and the correlation with laboratory hexokinase measurement in the hypoglycemic and hyperglycemic ranges is poor with most meters currently available (7,8 ). Thus there is still concern about the use of glucose meters for management of TGC in the ICU (9,10 ).…”