Influence of Simulated Altitude on the Performance of Five Blood Glucose Meters

Gautier, Jean‐François; Bigard, A. X.; Douce, P.; Duvallet, Alain; Cathelineau, G

doi:10.2337/diacare.19.12.1430

Cited by 38 publications

(22 citation statements)

References 8 publications

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“…[40][41][42][43][44] Both, under-and overestimated BG values have been observed, being a relatively lowered pO 2 the main reason for these measurement deviations. 22 Under decreasing pO 2 clinically relevant deviations with a risk of treatment errors have been demonstrated with some meters, 41,45 an effect normally related to increased BG readings. In a study conducted in Tanzania, 3 BG meters taken to Mt Kilimanjaro (>5800 m) showed BG readings of 50, 214, and 367 mg/dL on the same sample.…”

Section: Altitudementioning

confidence: 99%

Interferences and Limitations in Blood Glucose Self-Testing

Erbach¹,

Freckmann²,

Hinzmann³

et al. 2016

J Diabetes Sci Technol

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Self-monitoring of blood glucose (SMBG) both in insulintreated and non-insulin-treated people with diabetes is supported by recently published trials, reviews, meta-analyses, and guidelines. [1][2][3][4][5][6][7] SMBG is recommended to be performed in a structured approach. 2,5,8,9 It is reported to be only useful when blood glucose (BG) data are interpreted and utilized for immediate therapeutic actions. 3,4,[10][11][12][13] For instance, the need for adequate dosing of insulin heavily depends on reliable glucose information. 8 In particular, patients with insulintreated diabetes perform SMBG as a substantial element of daily management of diabetes.14,15 The term "BG system" denotes the combination of a BG meter and test strips, and both determine analytical performance. 8 The analytical and handling performance of BG systems has largely improved over the past decades. In addition, the implementation of inmeter safety features (ie, validity of test strips check) has further increased the safety of these devices. 16 Consequently, patients with appropriate training and a good performance of BG testing can typically rely on the precision of BG measurement results. However, in the daily practice a range of factors with potential impact on the reliability of BG measurement needs to be considered. In fact, this is an important aspect in field of point-of-care (POC) testing. 17 Members of the diabetes team and patients should be well informed about all factors potentially falsifying BG measurement results: human, meter-inherent, test-strip-inherent, environmental, physiological, and medication-related impact factors (Table 1).The risk of misinterpretation of BG readings can be minimized by detailed information on the factors potentially affecting BG measurement. Hence, the aim of this publication is to review the current knowledge on limitations and interferences significant for reliable BG testing.Nonetheless, due to the rapid technological progress, it should be kept in mind that performance of most more recent BG meters may not always be reflected by the reviewed literature, since it reports on data generated with older BG generations. 17 Moreover, it is important to note that some studies on limitations of BG meters were performed under extreme conditions which do not comply with the approved conditions of usage. AbstractIn general, patients with diabetes performing self-monitoring of blood glucose (SMBG) can strongly rely on the accuracy of measurement results. However, various factors such as application errors, extreme environmental conditions, extreme hematocrit values, or medication interferences may potentially falsify blood glucose readings. Incorrect blood glucose readings may lead to treatment errors, for example, incorrect insulin dosing. Therefore, the diabetes team as well as the patients should be well informed about limitations in blood glucose testing. The aim of this publication is to review the current knowledge on limitations and interferences in blood glucose testing with the perspective of the...

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Section: Altitudementioning

confidence: 99%

Interferences and Limitations in Blood Glucose Self-Testing

Erbach¹,

Freckmann²,

Hinzmann³

et al. 2016

J Diabetes Sci Technol

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“…Low blood oxygen tension theoretically would cause glucose oxidase-based meters to over-read, which was reported to be as much as 6%-15% in one study where glucose dehydrogenase-based strips were more accurate at altitude (Oberg and Ostenson, 2005), whereas other studies have shown the converse at moderate altitude (Olateju et al, 2012). Several studies confirm over-or under-reading at altitude of both reagents (Bilen et al, 2007;Fink et al, 2002;Gautier et al, 1996;Giordano et al, 1989;Olateju et al, 2012;Pavan et al, 2004;Pecchio et al, 2000) and discrepancy between simulated and real altitude (de Mol et al, 2010). Technological improvement may reduce these errors (Bailey et al, 2012;Lock et al, 2011) and in any case the clinical effect would appear minimal unless over-reading on the borders of hypoglycemia.…”

Section: Glucometersmentioning

confidence: 89%

The Practical Aspects of Insulin at High Altitude

Richards

Hillebrandt

2013

High Altitude Medicine & Biology

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With the increasing prevalence of diabetes and current social philosophy of enablement, many more diabetics are travelling to high altitude where the rate of AMS in Type 1 diabetic mountaineers is no different than nondiabetics. Numerous effects of exercise, both degree and duration, dietary change, illness, stress, mountain sickness, counter-regulatory hormones, and altitude increased sympathetic output, and catecholamines have led to conflicting accounts of insulin requirement increasing or decreasing at altitude. Overall, it would appear that the effects of diet and exercise outweigh those of altitude. Good control requires continual insulin dose adjustment with frequent feedback from blood sugar testing, but glucometers can over- or under-read at altitude. Additionally, heat or cold exposure can degrade insulin efficacy; strategies for storing insulin are described.

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“…Although these findings have not been confirmed scientifically, most climbers rely on this shared information for high altitude BG monitoring. Studies on the reliability of these devices have been performed at altitudes below 4000 m or with models that are now outdated (Giordano et al, 1989;Piepmeier et al, 1995;Gautier et al, 1996;Fanghanel et al, 1998;Pecchio et al, 2000;Williams and Petoskey, 2000). Hemoconcentration, very frequent at altitude, may cause an underestimation in the results (Barreau and Buttery, 1988).…”

Section: Altitude Environment and Dm-1 Managementmentioning

confidence: 97%

Going High with Type 1 Diabetes

Leal

2005

High Altitude Medicine & Biology

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This review aims to identify the main issues facing a healthy and well-controlled type-1 diabetic mountaineer at high altitude. Most of the problems are self-managed by the diabetic climber although the risk of serious morbidity or even death remains. Given the scarce evidence on diabetes at altitude, an extensive search of the literature, including case reports and anecdotes was carried out to reach the recommendations.

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Influence of Simulated Altitude on the Performance of Five Blood Glucose Meters

Cited by 38 publications

References 8 publications

Interferences and Limitations in Blood Glucose Self-Testing

Interferences and Limitations in Blood Glucose Self-Testing

The Practical Aspects of Insulin at High Altitude

Going High with Type 1 Diabetes

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