Impact of prandial status on the comparison of capillary glucose meter and venous plasma glucose measurements in healthy volunteers

Swaminathan, Akhilesh; Lunt, Helen; Chang, Winston S. J.; Logan, Florence J; Frampton, Christopher M.; Florkowski, Christopher M

doi:10.1258/acb.2012.012084

Cited by 9 publications

(15 citation statements)

References 26 publications

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“…Another consideration is the difference in sample type. In the fasting state, capillary whole blood glucose is 11% lower when compared with venous plasma glucose [33]. This difference is mostly due to the difference in water content between the two samples.…”

Section: Discussionmentioning

confidence: 93%

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A comparison between point‐of‐care testing and venous glucose determination for the diagnosis of diabetes mellitus 6–12 weeks after gestational diabetes

et al. 2019

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Aim To evaluate point-of-care-testing (POCT) for the diagnosis of Type 2 diabetes mellitus 6-12 weeks post-partum in women with gestational diabetes (GDM).Methods Post-partum glucose assessment (75-mg oral glucose tolerance test, OGTT) was performed prospectively in 122 women with GDM (1 November 2015 to 1 November 2017) at Tygerberg Hospital, Cape Town, South Africa. Individuals with known pre-existing diabetes were excluded. The accuracy and clinical utility of POCT (capillary fingerprick) were compared with laboratory plasma glucose (hexokinase and glucokinase methods). The OGTT consisted of two time points (fasting and 2 h) during which concurrent glucose samples (POCT and laboratory) were obtained. Bland-Altman plots and paired analysis were used to assess the analytical accuracy of POCT, whereas its diagnostic performance was determined using positive and negative predictive values to calculate specificity and sensitivity.Results Spearman's ranked correlation analysis indicated a strong association between POCT and laboratory glucose values at both OGTT time points (fasting, r = 0.95, P < 0.0001; 2 h, r = 0.88, P < 0.0001). Thirty-six women were diagnosed with Type 2 diabetes based on gold standard laboratory glucose levels (fasting > 7 mmol/l; 2 h > 11.1 mmol/ l). POCT correctly identified Type 2 diabetes in 78% of women (28 of 36) with a positive predictive value of 89.3% and a negative predictive value of 96.7% at the fasting time point. The sensitivity and specificity of POCT to diagnose Type 2 diabetes were 89% (fasting), 85.7% (2 h) and 96.7% (fasting), 98.5% (2 h) respectively. POCT proved less sensitive to diagnose pre-diabetes (69%) but displayed satisfactory specificity (92%) at both time points assessed.Conclusion POCT accurately identifies women with Type 2 diabetes 6-12 weeks after GDM.

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Section: Discussionmentioning

confidence: 93%

“…POCT proved to be most valuable for the diagnosis of Type 2 diabetes utilizing fasting values. In addition, there is an arterio-venous glucose gradient that becomes more pronounced following a carbohydrate load due to improved peripheral glucose uptake [33]. 2a).…”

Section: Discussionmentioning

confidence: 99%

A comparison between point‐of‐care testing and venous glucose determination for the diagnosis of diabetes mellitus 6–12 weeks after gestational diabetes

et al. 2019

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“…Tissue uptake of glucose produces an arterial-capillaryvenous gradient in glucose concentration, first described around 160 years ago [1]. Multiple publications have confirmed that, after ingestion of an oral nutrient load, a glucose gradient occurs of~1-2 mmol/l in magnitude [2][3][4][5][6][7][8][9][10][11][12][13]. In healthy volunteers, the gradient in peripheral tissue is minimal in the fasting state and maximal at~30-60 min after oral carbohydrate intake [2].…”

Section: Introductionmentioning

confidence: 99%

Postprandial capillary–venous glucose gradient in Type 1 diabetes: magnitude and clinical associations in a real world setting

et al. 2015

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AimsTo determine the magnitude of the peripheral glucose gradient in patients with Type 1 diabetes in a real world setting and to explore its relationship with insulin dose and macronutrient intake.MethodsAll patients used mealtime analogue insulin. The glucose gradient was assessed using antecubital fossa venous and finger‐stick capillary samples, collected concurrently at room temperature. Baseline sampling occurred before the administration of an insulin dose and breakfast of the patient's choosing. Breakfast was consumed an average of 15 min after baseline. The macronutrient content of breakfast was documented. Sampling was repeated 1 and 2 h after baseline.ResultsThe mean (95% CI) plasma capillary–venous glucose gradient values for 43 patients were: pre‐breakfast, 0.21 (0.08–0.34) mmol/l; 1 h after baseline, 0.87 (0.66–1.07) mmol/l; and 2 h after baseline, 0.52 (0.33–0.71) mmol/l. Glucose gradient and dietary carbohydrate intake (g/kg body weight) were positively correlated at both 1 h (P < 0.01) and 2 h after baseline (P < 0.01). No relationship was observed between this gradient and mealtime insulin dose, or the glucose concentration at either time point.ConclusionsIn patients with Type 1 diabetes, a clinically significant glucose gradient is present after the ingestion of a carbohydrate‐rich meal. As postprandial capillary and venous plasma glucose concentrations are not equivalent, defining the site of sample collection is important.

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“…Additional methodology is described in detail elsewhere. 2 Statistical comparisons were undertaken using unpaired two tailed t-tests, simple linear regression and 2 tests. P < 0.05 was considered to be significant.…”

Section: Methodsmentioning

confidence: 99%

“…This study aims to add to our knowledge of the random glucose range by describing the one hour post breakfast venous plasma glucose results from healthy individuals, obtained as part of a previous study. 2 …”

Section: Introductionmentioning

confidence: 99%

What is the lower limit for postprandial venous plasma glucose in healthy young adults?

et al. 2013

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Background: There is general agreement that the lower limit for postprandial venous plasma glucose is the same or higher than for a fasted sample. The finding of a postprandial fall in glucose would therefore have implications for assignment of the lower limit of the normal glucose range. Methods: An antecubital venous sample was collected before and one hour after breakfast. Plasma was separated immediately after collection and glucose measured using the hexokinase method. Participants with dysglycaemia were excluded from subsequent analysis. Results: Glucose range (mmol/L) for the 96 participants was 4.4-6.0 fasting and 2.7-7.2 postprandially. There was no relationship between postprandial glucose and either gender or carbohydrate intake. About 24% of postprandial concentrations were <3.9 mmol/L. Conclusions: If laboratories choose to define a random venous plasma glucose reference range, the lower limit should be below 3.9 mmol/L.

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Impact of prandial status on the comparison of capillary glucose meter and venous plasma glucose measurements in healthy volunteers

Abstract: In healthy volunteers, both glucose meters showed a systematic positive bias one hour after breakfast. The significance of this finding in diabetes remains to be determined.

Cited by 9 publications

References 26 publications

A comparison between point‐of‐care testing and venous glucose determination for the diagnosis of diabetes mellitus 6–12 weeks after gestational diabetes

A comparison between point‐of‐care testing and venous glucose determination for the diagnosis of diabetes mellitus 6–12 weeks after gestational diabetes

Postprandial capillary–venous glucose gradient in Type 1 diabetes: magnitude and clinical associations in a real world setting

What is the lower limit for postprandial venous plasma glucose in healthy young adults?

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