Influence of blood sample oxygen tension on blood glucose concentration measured using an enzyme-electrode method

Abstract

Blood glucose values measured using a bedside glucometer in this study were influenced by the sample oxygen tension. We used a corrective equation which improved the accuracy of estimating blood glucose values to a clinically acceptable range.

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

“…[14][15][16][17][18][19] Increased pO 2 values can occur in patients requiring artificial respiration. 9,11,20 In this study, at ''high'' pO 2 values the GOD systems showed a negative bias for the measurement results compared with those at pO 2 values approximately 70 mm Hg. 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.…”

“…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.…”

“…4,[6][7][8] Previous investigations have shown that increases of the partial pressure of oxygen (pO 2 ) in blood samples result in considerable measurement bias of some oxygen-dependent GOD systems. [7][8][9][10][11] Over-or underestimated blood glucose (BG) values of a given SMBG system can result in undetected hypo-or hyperglycemic events and may adversely affect therapeutic decisions.…”

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

“…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.…”

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

“…However, oxygen, a confounding variable, can affect glucose meter measurements. [1][2][3][4][5] In our previous study, 6 we observed that changes in blood oxygen tension (Po 2 ) can affect glucose measurements on handheld glucose meters with some of latest test strips. A whole-blood/plasma glucose analyzer, the YSI, served as the reference method.…”