Interferences and Limitations in Blood Glucose Self-Testing

Abstract

Self-monitoring of blood glucose (SMBG) both in insulintreated and non-insulin-treated people with diabetes is supported by recently published trials, reviews, meta-analyses, and guidelines. [1][2][3][4][5][6][7] SMBG is recommended to be performed in a structured approach. 2,5,8,9 It is reported to be only useful when blood glucose (BG) data are interpreted and utilized for immediate therapeutic actions. 3,4,[10][11][12][13] For instance, the need for adequate dosing of insulin heavily depends on reliable glucose information. 8 In particular, patients with insulintreated diabetes perform SMBG as a substantial element of daily management of diabetes.14,15 The term "BG system" denotes the combination of a BG meter and test strips, and both determine analytical performance. 8 The analytical and handling performance of BG systems has largely improved over the past decades. In addition, the implementation of inmeter safety features (ie, validity of test strips check) has further increased the safety of these devices. 16 Consequently, patients with appropriate training and a good performance of BG testing can typically rely on the precision of BG measurement results. However, in the daily practice a range of factors with potential impact on the reliability of BG measurement needs to be considered. In fact, this is an important aspect in field of point-of-care (POC) testing. 17 Members of the diabetes team and patients should be well informed about all factors potentially falsifying BG measurement results: human, meter-inherent, test-strip-inherent, environmental, physiological, and medication-related impact factors (Table 1).The risk of misinterpretation of BG readings can be minimized by detailed information on the factors potentially affecting BG measurement. Hence, the aim of this publication is to review the current knowledge on limitations and interferences significant for reliable BG testing.Nonetheless, due to the rapid technological progress, it should be kept in mind that performance of most more recent BG meters may not always be reflected by the reviewed literature, since it reports on data generated with older BG generations. 17 Moreover, it is important to note that some studies on limitations of BG meters were performed under extreme conditions which do not comply with the approved conditions of usage. AbstractIn general, patients with diabetes performing self-monitoring of blood glucose (SMBG) can strongly rely on the accuracy of measurement results. However, various factors such as application errors, extreme environmental conditions, extreme hematocrit values, or medication interferences may potentially falsify blood glucose readings. Incorrect blood glucose readings may lead to treatment errors, for example, incorrect insulin dosing. Therefore, the diabetes team as well as the patients should be well informed about limitations in blood glucose testing. The aim of this publication is to review the current knowledge on limitations and interferences in blood glucose testing with the perspective of the...

Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: A narrative review

“…Self‐monitoring of blood glucose levels (SMBGL) is widely accepted as being beneficial for long‐term glycemic control in type 2 diabetes, both with or without insulin therapy. However, limitations and poor adherence to regular SMBGL exist due to inconvenience, costs of disposables, and erroneous and reduced measurement frequency resulting in suboptimal glycemic control. Alternatively, continuous glucose monitoring systems (CGM) have emerged that utilize sensor technology inserted subcutaneously to measure interstitial glucose levels across the day that could enhance behavior change adherence and glycemic control.…”

Estimating plasma glucose with the FreeStyle Libre Pro continuous glucose monitor during oral glucose tolerance tests in youth without diabetes

“…Replacing or supplementing self‐measured blood glucose with CGM data can be useful in mitigating inaccuracies in self‐measured blood glucose due to human error, physiological discrepancies, medication interference, or extreme environmental conditions and may be deemed more acceptable to patients and research volunteers. If found to read glucose accurately, the FLP system would seem a valuable CGM for pediatric research use due to the extended, 14‐day sensor wear time, factory calibration, and usability of the device .…”

“…We sought to evaluate the accuracy and feasibility of the FLP glucose monitor in children without diabetes. We examined the accuracy of Replacing or supplementing self-measured blood glucose with CGM data can be useful in mitigating inaccuracies in self-measured blood glucose due to human error, physiological discrepancies, medication interference, or extreme environmental conditions [29][30][31] and may be deemed more acceptable to patients and research volunteers.…”

Comparison of analytical methods for rapid & reliable quantification of plant-based carbohydrates for the quintessential bioenergy educator

“…This work highlights the variability in some glucometer test strips for detection of sugars in non-blood based samples and under non-ideal self-testing conditions. 23,34 However, this could also reflect the manufacturer associated product quality issues as suggested by a recent 2016 FDA regulated recall of some Trividia Health TRUETest glucometer test strips. 35 In terms of ease of use, only the glucometer-based kits required limited user training with minimal handling of pipettes/micropipettes if all stock reagents and standards are prepared ahead of time by the instructor or support staff.…”