Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood

Hortensius, J.; Slingerland, R. J.; Kleefstra, Nanne; Logtenberg, S. J. J.; Groenier, Klaas H.; Houweling, S. T.; Bilo, Henk J. G.

doi:10.2337/dc10-1694

Cited by 63 publications

(54 citation statements)

References 8 publications

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“…Various studies have been conducted to estimate the accuracy of glucometers in comparison with a standard laboratory method [4][5][6]. However, limited work has been done in Pakistan regarding the accuracy of glucometers in comparison with laboratory methods in this social setting.…”

Section: Brief Communication (Original)mentioning

confidence: 99%

Correlation between capillary and venous blood glucose levels in diabetic patients

et al. 2015

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Background: Rapid blood glucose estimation is required to prescribe treatments and to make dose adjustments in diabetic patients. However, measuring plasma glucose levels is time consuming. Therefore, the use of glucometers has greatly increased. Objectives: To measure the correlation between capillary and venous blood glucose levels. Methods: Seventy patients with type 2 diabetes mellitus (T2DM) were enrolled in the present study and informed written consent was obtained from all participants. Demographic characteristics and clinical information was noted. Capillary and venous glucose levels were determined. Statistical Package for Social Sciences version 21 was used for data analysis. Results: Mean age of patients was 52 ± 12 years. It included 29% men; 71% women; 9% smokers; and 90% poor. Mean venous glucose was 11.73 ± 4.64 mmol/L and mean capillary glucose 12.57 ± 5.21 mmol/L. These findings demonstrated a significant intermethod mean difference of 0.84 mmol/L (P < 0.001). Inter-glucose difference was not significant at glucose levels near normal. However, it increased gradually with rise in glucose measurements and was significant at elevated glucose levels. Both concordance correlation coefficient and intraclass correlation coefficient demonstrated positive correlation and more consistency between glucose estimations. A Bland and Altman plot presented excellent agreement between glucometrically and photometrically determined glucose levels. Conclusion: A positive correlation coefficient showed strong association between capillary and venous glucose measurements.

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Section: Brief Communication (Original)mentioning

confidence: 99%

Correlation between capillary and venous blood glucose levels in diabetic patients

et al. 2015

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“…If washing hands is not possible, and they are not visibly soiled or exposed to a sugar-containing product, it is acceptable to use the second drop of blood after wiping away the first drop. Firm squeezing of the finger should be avoided (9,10).…”

Section: Choosing the Correct Blood Samplementioning

confidence: 99%

“…The meters that give "plasma equivalent" readings have a built in algorithm, that translates the whole blood measurement, to make it seem like the result that would be obtained on a plasma sample. It is important to know whether the particular meter gives its results as "whole blood equivalent" or "plasma equivalent" (8,9,10).…”

Section: Analytical Variables Whole Blood Glucose Vs Plasma Glucosementioning

confidence: 99%

How reliable are capillary blood glucose measurements?

Rajaratnam¹,

Pathmanathan²

2012

Sri Lanka J. Diabetes Endocrinol. Metab.

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Capillary blood tests measure whole blood glucose as opposed to venous samples which measure plasma glucose. It is used for the care of people with diabetes, as a monitoring tool, giving a guide to blood glucose levels, at a specific moment in time. Capillary blood glucose monitoring was first established in the 1970s using glucometers. With time, the use of glucometers has become easier and faster, with much smaller blood samples, yielding results in a matter of seconds. Today they are used routinely in health care, for the easier achievement of glycaemic targets and diabetic emergencies. Without such technology, intensive glucose control including insulin pump therapy would not have become a reality. Glucometers have also relieved a great amount of anxiety over the management of hypoglycaemia. Today however, we rely so much on capillary blood glucose measurements forgetting its limitations. This article will discuss the pitfalls and limitations of capillary blood glucose monitoring (1, 2). Accuracy goals for home glucose monitorsThe goals for glucometer accuracy have been quite variable. Clarke et al. proposed an accuracy grid to establish a more expansive set of goals for glucometer usage taking into account clinical accuracy, defined as within 20% of the laboratory glucose (3). For glucose levels above 75 mg/dl, the International Organization for Standardization (ISO) recommends a goal for glucometer error of within 20% when compared with a reference glucose sample, but for glucose levels less than 75 mg/dl, the goal is for 95% of readings to be within 15 mg/dl of the reference. The U.S. Food and Drug Administration goal for glucometers is within 20% of the reference value, when glucose is greater than 100 mg/dl and within 20 mg/dl when glucose is less than 100 mg/dl (4, 5).Although there is no universally binding standard, guidelines issued by ISO are widely acknowledged. Assuming a meter meets the ISO guideline, then a true glucose level of 55 mg/dl could in fact yield a reading of as low as 40 or as high as 70 mg/dl. It could be particularly hazardous in a patient with hypoglycaemia unawareness who would consider the reading of 70 mg/dl as reassuring for a true value of 55 mg/dl, which needs prompt corrective action. At the other end of the spectrum, a true value of 350 mg/dl might register as low as 280 or as high as 420 mg/dl. This could have some consequences, especially in intensive care situations, where insulin infusion algorithms aim at achieving tight glycaemic control (4).

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“…Desse modo, o estudo recomenda que a primeira escolha deve ser: lavar as mãos com água e sabão, secá-las bem e utilizar a primeira gota de sangue para realizar o exame. Caso a lavagem das mãos não seja possível, é aceitável que se use a segunda gota de sangue, após limpar a primeira gota com um lenço de papel, desde que a pessoa não tenha tido contato com frutas ou qualquer outra substância que possa alterar o valor da glicemia (55) .…”

Section: American Diabetes Association (Ada) International Diabetes unclassified

“…Sendo assim, confere-se à questão da higiene das mãos uma importância singular para os pacientes com diabetes, pois além do risco aumentado de infecções, há implicações diretas nos resultados da glicemia capilar que depende da higienização correta das mãos, como discutido acima (55) . O risco aumentado de infecções ainda não está totalmente esclarecido.…”

Section: American Diabetes Association (Ada) International Diabetes unclassified

Oficina educativa sobre monitorização glicêmica para crianças escolares com diabetes mellitus tipo 1

Kaneto¹

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Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood

Cited by 63 publications

References 8 publications

Correlation between capillary and venous blood glucose levels in diabetic patients

Correlation between capillary and venous blood glucose levels in diabetic patients

How reliable are capillary blood glucose measurements?

Oficina educativa sobre monitorização glicêmica para crianças escolares com diabetes mellitus tipo 1

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