Glycemic Variability in the Use of Point-of-Care Glucose Meters

Hellman, Richard

doi:10.2337/diaspect.25.3.135

Cited by 5 publications

(4 citation statements)

References 27 publications

(31 reference statements)

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“…der Verlaufskurven steht der Wunsch der Patienten, neben den qualitätsgesicherten labormedizinischen Befunden auch Messwerte aus anderen Quellen mit sehr unterschiedlichen Leistungsspezifika der verwendeten Methoden in seiner elektronischen Akte zu speichern. Hierunter fallen einmal die direkt vom Patienten im Rahmen der Selbstmessung erhobenen Daten wie die Blutglucosewerte bei der Selbstmessung [40] oder auch die POCT-INR-Werte [41]. Andere Messwerte könnten z.B.…”

Section: Befundungunclassified

Chancen und Risiken von e-Health in der Labormedizin

Orth¹,

Aufenanger

Hoffmann³

et al. 2016

LaboratoriumsMedizin

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ZusammenfassungAus dem Lifestyle- und Wellnessbereich werden den Kunden vielfältige Apps angeboten, die die Kundendaten ansprechend digital präsentieren. Auch der politische Wille fordert die Digitalisierung in der Medizin mit dem sog. „E-Health-Gesetz“. In der nationalen elektronischen Patientenakte sollen dazu auch Laborbefunde gespeichert werden. Dafür notwendig ist allerdings eine ausreichende Harmonisierung von Prä-Präanalytik (Terminologie, Testprofile, Testungsintervalle), Präanalytik (Abnahmezeiten, Patientenvorbereitung, Probentransport und Probenlagerung), Analytik (Probenqualität, Methode, Kalibration, Qualitätssicherung) bis hin zur Postanalytik (Einheiten, Datenformate, Referenzintervalle, Entscheidungswerte). Diese Harmonisierung kann aufgrund der vielen verschiedenen Laboruntersuchungen und parameterspezifischen Besonderheiten trotz weitreichender nationaler und internationaler Aktivitäten noch nicht als abgeschlossen gelten. Andere Herausforderungen elektronischer Patientenakten liegen bei der Datensicherheit (d.h. der Integrität der Laborbefunde) und dem Datenschutz unter Berücksichtigung der informationellen Selbstbestimmung der Patienten und weiterer Gesetze wie dem Gendiagnostikgesetz (GenDG).Empfehlung:Wir empfehlen aus Gründen der Patientensicherheit, sich bei der nationalen elektronischen Patientenakte auf wenige ausgewählte Laborbefunde zu beschränken, die unmittelbar zur Dosisanpassung von Medikamenten notwendig sind und die so den elektronischen Medikationsplan unterstützen.

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Section: Befundungunclassified

Chancen und Risiken von e-Health in der Labormedizin

Orth¹,

Aufenanger

Hoffmann³

et al. 2016

LaboratoriumsMedizin

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“…Different POC glucose meters are on the market and hence there is an increase in variability of the results given by these meters. Manufacturers' adherence to standards of ISO 15197 has over the years been seen to be compromised (Hellman, 2012). Test strips used for these POC glucose meters has also seen to be compromised by some manufacturers.…”

Section: Introductionmentioning

confidence: 99%

“…Blood glucose testing by POC meters has revolutionized the monitoring of diabetes in recent times by giving relatively accurate measurements of the actual blood glucose of patients in real time (Hellman, 2012). For instance, the difference in glucose levels given by different meters may be as great as 50-70 mg/dl (Dungan et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

A comparative study of glycaemic variability using four different Point-of-Care Testing (POCT) devices

et al. 2021

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Background: Blood glucose measurement is a way of monitoring changes in glycaemia. Different point-of-care testing (POCT) glucose meters are on the market and hence there is an increase in variability of the results given by these meters. This study sought to measure the glycaemic variability using four different point-of-care glucose meters Methods: Four point of care glucometers namely; Accu-chek performer nano, OneTouch select plus flex, OneTouch Ultra 2 and Easy Check were used test blood samples from a total of 100 patients visiting the collection point of the Tamale Teaching Hospital Laboratory. A chemistry analyzer (Mindray BS 240 fully automated) was used as the reference method. Results: The median (interquartile range), Bland Altman Plot and Regression Equation were used to assess the agreement between the various meters and the reference method. The OneTouch Select plus had the least bias (-0.85) and the the OneTouch Ultra 2 had the highest bias (1.49). The OneTouch select had the best limits of agreement (-2.51 – 0.82) and the OneTouch Ultra 2 had the widest limits of agreement (-1.91 – 4.89) when compared to the reference method. Conclusion: OneTouch Select plus had the best agreement with the reference method and the OneTouch Ultra 2 had the least agreement with the reference method. Blood glucose meters should be used for the monitoring of blood glucose however, it should not be used as a diagnostic tool. Annals of Medical Laboratory Science (2021) 1(2), 1 - 8 Keywords: glucometer, point-of-care, blood glucose, glycaemia

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“…These studies have examined feasibility and reliability, quality assurance, 39 acceptability, 40 and challenges associated with POC screening. Deterrents to POC screening to date include cost; reimbursement structures; requirement for dental practices to address Clinical Laboratory Improvement Amendment (CLIA) certification; POC HbA1c sensitivity (estimated at ~65%); 41 variability of glucometer accuracy; 42 and operator competency training/tracking requirement 39 for POC screening. These collectively contribute potential for high false positive rates and low patient/provider acceptability.…”

Section: Future Directions In Screeningmentioning

confidence: 99%

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients

2017

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Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oralsystemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously-and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes.

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Glycemic Variability in the Use of Point-of-Care Glucose Meters

Cited by 5 publications

References 27 publications

Chancen und Risiken von e-Health in der Labormedizin

Chancen und Risiken von e-Health in der Labormedizin

A comparative study of glycaemic variability using four different Point-of-Care Testing (POCT) devices

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients

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