Oxygen Effects on Glucose Measurements with a Reference Analyzer and Three Handheld Meters

Tang, Zuping; Louie, Richard F.; Payes, Marta; Chang, Kai-Chiao J.; Kost, Gerald J.

doi:10.1089/15209150050194215

Cited by 60 publications

(30 citation statements)

References 26 publications

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“…Several previous studies reported that some test strips, especially those with glucose oxidase enzyme reaction, are sensitive to oxygen and that high oxygen concentrations may lead to system results lower than the true value. [29][30][31][32][33] Most of the published system accuracy evaluation studies either do not evaluate samples with BG concentration <80 and ≥300 mg/dl (or not sufficient numbers) or use venous blood. [34][35][36][37][38][39] Main reasons for doing so are most likely the difficulty of designing a controlled human study or an adequate procedure to obtain capillary blood samples in hypoglycemic and hyperglycemic ranges.…”

Section: Discussionmentioning

confidence: 99%

System Accuracy Evaluation of 43 Blood Glucose Monitoring Systems for Self-Monitoring of Blood Glucose according to DIN EN ISO 15197

Freckmann

Schmid

Baumstark

et al. 2012

J Diabetes Sci Technol

221

194

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Section: Discussionmentioning

confidence: 99%

System Accuracy Evaluation of 43 Blood Glucose Monitoring Systems for Self-Monitoring of Blood Glucose according to DIN EN ISO 15197

Freckmann

Schmid

Baumstark

et al. 2012

J Diabetes Sci Technol

221

194

View full text Add to dashboard Cite

“…This is in line with several other studies reporting that some GOD systems underestimate BG values when measurements were performed on blood samples with increased pO 2 values. 8,9,11,21 In such studies, measurements on adjusted venous blood samples with pO 2 values >100 mm Hg or in critically ill patients/patients undergoing surgery with increased arterial pO 2 values up to approximately 600 mm Hg resulted in a negative bias. Probably, the competition between dissolved oxygen in the blood sample and the electron acceptor on the biosensor of test strips leads to a diminished chemical reaction when the blood samples' pO 2 value is increased.…”

Section: Discussionmentioning

confidence: 99%

Impact of Partial Pressure of Oxygen in Blood Samples on the Performance of Systems for Self-Monitoring of Blood Glucose

Schmid

Baumstark

Pleus

et al. 2014

Diabetes Technology & Therapeutics

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Background: The partial pressure of oxygen (pO 2 ) in blood samples can affect glucose measurements with oxygen-sensitive systems. In this study, we assessed the influence of different pO 2 levels on blood glucose (BG) measurements with five glucose oxidase (GOD) systems and one glucose dehydrogenase (GDH) system. All selected GOD systems were indicated by the manufacturers to be sensitive to increased oxygen content of the blood sample. Materials and Methods: Venous blood samples of 16 subjects (eight women, eight men; mean age, 52 years; three with type 1 diabetes, four with type 2 diabetes, and nine without diabetes) were collected. Aliquots of each sample were adjusted to the following pO 2 values: £ 45 mm Hg, approximately 70 mm Hg, and ‡ 150 mm Hg. For each system, five consecutive measurements on each sample were performed using the same test strip lot. Relative differences between the mean BG value at a pO 2 level of approximately 70 mm Hg, which was considered to be similar to pO 2 values in capillary blood samples, and the mean BG value at pO 2 levels £ 45 mm Hg and ‡ 150 mm Hg were calculated. Results: The GOD systems showed mean relative differences between 11.8% and 44.5% at pO 2 values £ 45 mm Hg and between -14.6% and -21.2% at pO 2 values ‡ 150 mm Hg. For the GDH system, the mean relative differences were -0.3% and -0.2% at pO 2 values £ 45 mm Hg and ‡ 150 mm Hg, respectively. Conclusions: The magnitude of the pO 2 impact on BG measurements seems to vary among the tested oxygen-sensitive GOD systems. The pO 2 range in which oxygen-sensitive systems operate well should be provided in the product information.

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“…[40][41][42][43] Point-of-care device test strips using glucose oxidase (see later) are prone to errors caused by oxygen effects. Tang and colleagues showed that errors of 15% or more could occur with highly oxygenated blood samples (i.e., PaO 2 >100 mm Hg), 44 and variances of up to 46% from reference values have been observed under hyperbaric conditions. [45][46][47][48] These devices have also been shown…”

Section: Terminologymentioning

confidence: 99%

Challenges to Glycemic Measurement in the Perioperative and Critically Ill Patient: A Review

Pitkin

Rice

2009

J Diabetes Sci Technol

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Accurate monitoring of glucose in the perioperative environment has become increasingly important over the last few years. Because of increased cost, turnaround time, and sample volume, the use of central laboratory devices for glucose measurement has been somewhat supplanted by point-of-care (POC) glucose devices. The trade-off in moving to these POC systems has been a reduction in accuracy, especially in the hypoglycemic range. Furthermore, many of these POC devices were originally developed, marketed, and received Food and Drug Administration regulatory clearance as home use devices for patients with diabetes. Without further review, many of these POC glucose measurement devices have found their way into the hospital environment and are used frequently for measurement during intense insulin therapy, where accurate measurements are critical. This review covers the technology behind glucose measurement and the evidence questioning the use of many POC devices for perioperative glucose management.

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Oxygen Effects on Glucose Measurements with a Reference Analyzer and Three Handheld Meters

Cited by 60 publications

References 26 publications

System Accuracy Evaluation of 43 Blood Glucose Monitoring Systems for Self-Monitoring of Blood Glucose according to DIN EN ISO 15197

System Accuracy Evaluation of 43 Blood Glucose Monitoring Systems for Self-Monitoring of Blood Glucose according to DIN EN ISO 15197

Impact of Partial Pressure of Oxygen in Blood Samples on the Performance of Systems for Self-Monitoring of Blood Glucose

Challenges to Glycemic Measurement in the Perioperative and Critically Ill Patient: A Review

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