Blood glucose overestimation in diabetic patients on continuous ambulatory peritoneal dialysis for end‐stage renal disease

Oyibo, Samson O; Pritchard, G.; McLay, L; James, E; Laing, Ian; Gokal, Ram; Boulton, A. J. M.

doi:10.1046/j.1464-5491.2002.00753.x

Cited by 48 publications

(13 citation statements)

References 9 publications

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“…Most GDH-based POC devices have significant overestimations of glucose in patients undergoing peritoneal dialysis using icodextrin as an osmotic agent [110,111]. Icodextrin is metabolized in the systemic circulation into different glucose polymers, but mainly maltose, which interferes with the GDH-PQQ-based method.…”

Section: Analytical Performance Validation Of Glucose Biosensorsmentioning

confidence: 99%

Glucose Biosensors: An Overview of Use in Clinical Practice

Yoo

Lee

2010

Sensors

921

556

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Blood glucose monitoring has been established as a valuable tool in the management of diabetes. Since maintaining normal blood glucose levels is recommended, a series of suitable glucose biosensors have been developed. During the last 50 years, glucose biosensor technology including point-of-care devices, continuous glucose monitoring systems and noninvasive glucose monitoring systems has been significantly improved. However, there continues to be several challenges related to the achievement of accurate and reliable glucose monitoring. Further technical improvements in glucose biosensors, standardization of the analytical goals for their performance, and continuously assessing and training lay users are required. This article reviews the brief history, basic principles, analytical performance, and the present status of glucose biosensors in the clinical practice.

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Section: Analytical Performance Validation Of Glucose Biosensorsmentioning

confidence: 99%

Glucose Biosensors: An Overview of Use in Clinical Practice

Yoo

Lee

2010

Sensors

921

556

View full text Add to dashboard Cite

show abstract

“…E-mail: nimalie.perera@email.cs.nsw.gov.au Virtually all glucose point-of-care devices use enzyme ⁄ cofactor systems that contain either glucose oxidase (GO) (oxygen sensitive) or microbial glucose dehydrogenase (GDH) (oxygen insensitive) coupled to either nicotine adenine dinucleotide (NAD) or pyrroloquinolinequinone (PQQ) cofactors. NAD is specific for glucose, with one known exception being xylose, while pyrroloquinolinequinone systems are not as specific and are affected by other sugars such as galactose and maltose [7][8][9][10][11]14,15]. Icodextrin is a glucose polymer used to maintain an osmotic gradient across the peritoneal membrane during peritoneal dialysis to facilitate prolonged and effective ultrafiltration.…”

Section: Introductionmentioning

confidence: 99%

The danger of using inappropriate point-of-care glucose meters in patients on icodextrin dialysis

et al. 2011

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While meters using glucose dehydrogenase/NAD are less affected by icodextrin metabolites, interference can still be demonstrated. The degree of interference can vary in different glucose meters using this enzyme/cofactor system, as seen in the Optium Xceed machines. Icodextrin is an important source of interference that sometimes even experienced professionals are unaware of and which leads to clinically significant errors in insulin dose adjustment. Awareness of this interference and selection of the most appropriate glucose meters are crucial to minimize this hazard.

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“…Wens et al were the first to describe this phenomenon 2. Since this initial report, few others have been described 2 – 4 , 6 – 8. Indeed, The Food and Drug Administration (FDA) have issued a warning in 2005 concerning this matter 9.…”

Section: Discussionmentioning

confidence: 99%

“…Icodextrin is a glucose polymer, commonly used as an osmotic agent in peritoneal dialysis solutions. Its metabolites, mainly maltose, are known to cause overestimation of blood glucose in assays utilising glucose dehydrogenase enzymatic reaction 2 – 4. Immunoglobulin for intravenous administration (IGIV) is an immunomodulatory agent frequently used in a wide variety of indications.…”

Section: Introductionmentioning

confidence: 99%

Severe unrecognised hypoglycaemia presenting as pseudonormoglycaemia and unexplained coma in two patients with renal failure

Galante

Abriel²,

Avnun³

et al. 2009

Case Reports

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We describe the occurrence of pseudonormoglycaemia and the consequences of severe prolonged hypoglycaemia observed in two patients with renal failure requiring renal replacement therapy. There was a persistent discrepancy, in both cases, between glucose levels measured by the hospital laboratory and those measured by the bedside glucometer, resulting in a significantly false high glucose measurement (pseudonormoglycaemia). This inaccurate glucose determination led to a delayed diagnosis of their truly severe and prolonged hypoglycaemia ultimately leading to prolonged coma and death. Icodextrin, a polysaccharide commonly used in continuous ambulatory peritoneal dialysis solutes, and maltose-containing solutions such as immunoglobulins for intravenous administration, can cause a dangerous overestimation of glucose levels determined by capillary blood glucose analysers utilising glucose dehydrogenase. A high level of awareness is required in order to avoid incidents related to misinterpretation of glucose levels.

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Blood glucose overestimation in diabetic patients on continuous ambulatory peritoneal dialysis for end‐stage renal disease

Abstract: The Precision Q.I.D System, which utilizes glucose oxidase reaction, is safe for use in diabetic patients treated with Icodextrin. All analysers must be cross-checked with the laboratory reference method before use in these patients.

Cited by 48 publications

References 9 publications

Glucose Biosensors: An Overview of Use in Clinical Practice

Glucose Biosensors: An Overview of Use in Clinical Practice

The danger of using inappropriate point-of-care glucose meters in patients on icodextrin dialysis

Severe unrecognised hypoglycaemia presenting as pseudonormoglycaemia and unexplained coma in two patients with renal failure

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