Investigation of the Potential for Interference with Whole Blood Glucose Strips

Sylvester, Emma; Price, C P; Burrin, J. M.

doi:10.1177/000456329403100118

Cited by 9 publications

(3 citation statements)

References 6 publications

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“…Ascorbic acid is one of the most common interfering substances that affects the accuracy of glucose meters. 14,15,34,35 Acetaminophen is taken extensively in the United States. Acetaminophen screening is warranted because of the frequency of occult presentation and the severity of toxic effects.…”

Section: Clinical Relevancementioning

confidence: 99%

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Tang

Louie

et al. 2000

American Journal of Clinical Pathology

202

145

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Thirty drugs used primarily in critical care and hospital settings were tested in vitro to observe interference on glucose measurements with 6 hand-held glucose meters and a portable glucose analyzer. Paired differences of glucose measurements between drug-spiked samples and unspiked control samples were calculated to determine bias. A criterion of +/- 6 mg/dL was used as the cutoff for interference. Ascorbic acid interfered with the measurements on all glucose devices evaluated. Acetaminophen, dopamine, and mannitol interfered with glucose measurements on some devices. Dose-response relationships help assessment of drug interference in clinical use. High dosages of these drugs may be given to critically ill patients or self-administered by patients without medical supervision. Package inserts for the glucose devices may not provide adequate warning information. Hence, we recommend that clinicians choose glucose devices carefully and interpret results cautiously when glucose measurements are performed during or after drug interventions.

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Section: Clinical Relevancementioning

confidence: 99%

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Tang

Louie

et al. 2000

American Journal of Clinical Pathology

202

145

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“…General anesthesia cannot take place without the administration of drugs. Multiple drugs, such as acetaminophen, dopamine and mannitol are known to increase or decrease POCT BG readings, depending on the type of device that is used [17][18][19][20]. In our hospital, acetaminophen is used as premedication.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Accu Chek Inform II point-of-care test blood glucose meter with Hexokinase Plasma method for a diabetes mellitus population during surgery under general anesthesia

Lascaris

Freling

Edens

et al. 2021

J Clin Monit Comput

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Purpose Blood glucose (BG) concentrations of patients with diabetes mellitus (DM) are monitored during surgery to prevent hypo- and hyperglycemia. Access to point-of-care test (POCT) glucose meters at an operating room will usually provide monitoring at shorter intervals and may improve glycemic control. However, these meters are not validated for patients under general anesthesia. Methods This cross-sectional study included 75 arterial BG measurements from 75 patients (71 with DM, mostly insulin dependent) who underwent elective non-cardiac surgery under general anesthesia. Arterial blood samples were taken at least 60 minutes after induction. One drop of blood was used for Accu Chek Inform II (ACI II) POCT BG meter and the residual blood was sent to the clinical laboratory for a Hexokinase Plasma reference method. A Bland–Altman plot was used to visualize the differences between both methods, and correlation was assessed using the intra-class correlation coefficient (ICC). Results The results showed an estimated mean difference of 0.8 mmol/L between ACI II and the reference method, with limits of agreement equal to -0.6 and 2.2 mmol/L. In general, the reference method produced higher values than ACI II. ICC was 0.955 (95% CI 0.634–0.986), P < 0.001, and concordance correlation coefficient (CCC) was 0.955 (95% CI 0.933–0.970). Conclusion Arterial BG measurements during surgery in patients with DM under general anesthesia using POCT BG meter are in general lower than laboratory measurements, but the ICC and CCC show a clinically acceptable correlation. We conclude that POCT measurements conducted on arterial specimens using the ACI II provide sufficiently accurate results for glucose measurement during surgery under general anesthesia.

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“…1 ) whose accuracy and clinical utility for 90- and 180-day periods have been validated in prospective, multisite clinical trials. 21 , 22 Although substances such as ascorbic acid, acetaminophen, dopamine, maltose, xylose, and mannitol can interfere with CGM systems that use electrochemical- and enzymatic- (i.e., glucose oxidase and glucose dehydrogenase) based methods to measure glucose concentrations, 9 , 11 , 12 , 15 , 23–25 the Eversense CGM sensor uses an abiotic (non–enzyme based), fluorescent glucose-indicating polymer to measure glucose 26 ( Fig. 2 ) and, therefore, may have a different drug interference profile.…”

Section: Introductionmentioning

confidence: 99%

Interference Assessment of Various Endogenous and Exogenous Substances on the Performance of the Eversense Long-Term Implantable Continuous Glucose Monitoring System

Lorenz

Sandoval

Mortellaro

2018

Diabetes Technology & Therapeutics

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Background: A variety of prescriptions and over-the-counter medications interfere with transcutaneous continuous glucose monitoring (CGM) sensors. This study characterized the interference profile of the Eversense® CGM System (Senseonics, Inc., Germantown, MD), which has a different mechanism of glucose detection than other CGM systems.Materials and Methods: Sensor bias (sensor glucose concentration measurement – plasma glucose concentration measured by a reference test) was measured in vitro against 41 different substances at supratherapeutic/supraphysiologic plasma concentrations. Testing was performed using a paired-sample method adapted from the Clinical and Laboratory Standards Institute guidance document EP7-A2. Any substance producing sensor bias that exceeded the International Organization for Standardization (ISO) document 15197:2013 limits was then tested using an in vitro dose–response method to determine whether the concentration producing a significant sensor bias was within physiologic/therapeutic concentration ranges.Results: Eight of 41 substances produced a sensor bias that exceeded ISO 15197:2013 limits when tested in vitro at supratherapeutic/supraphysiologic plasma concentrations. Only two of these substances (tetracycline and mannitol) exceeded bias limits within therapeutic concentration ranges. Notably, neither acetaminophen nor ascorbic acid, which are substances reported to interfere with other CGM systems, produced sensor bias that exceeded ISO limits when used at physiologic concentrations.Conclusions: Although tetracycline and mannitol interfered with the Eversense sensor, substances frequently reported to interfere with enzymatic, electrochemical-based transcutaneous CGM systems, such as acetaminophen and ascorbic acid, did not affect Eversense readings.

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Investigation of the Potential for Interference with Whole Blood Glucose Strips

Cited by 9 publications

References 6 publications

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Comparison of Accu Chek Inform II point-of-care test blood glucose meter with Hexokinase Plasma method for a diabetes mellitus population during surgery under general anesthesia

Interference Assessment of Various Endogenous and Exogenous Substances on the Performance of the Eversense Long-Term Implantable Continuous Glucose Monitoring System

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