[Evaluation of Optium Xceed (Abbott) and One Touch Ultra (Lifescan) glucose meters]

In order to build a continuous quality improvement approach for control of glucose meters in clinical divisions at Necker-Enfants Malades hospital, the analytical performances (precision and accuracy) of 2 glucose meters have been evaluated in our laboratory according to SFBC recommendations. Fifty-six heparinized whole blood specimens from patients and thirty-nine from healthy volunteers were analyzed on each of the two meters and compared to plasma glucose measurement on the Roche Hitachi 917 system. The correlation coefficient was 0.938 for Optium Xceed and 0.911 for One Touch Ultra. However, 14.7% and 18.9% of the results (n = 95) for respectively Optium Xceed and One Touch Ultra were discordant, i.e. higher than a 20% difference compared to reference blood glucose concentrations. Inaccuracy was more important for low glucose concentrations (< 5 mmol/L; 12/14 discrepant samples for Optium Xceed and 16/19 for One Touch Ultra). This data suggests a lack of accuracy, particularly for low glucose concentrations. Capillary blood glucose concentrations must therefore be interpreted with caution concerning the diagnosis of hypoglycemia and treatment of unstable patients. Moreover, quality control of glucose meters (blood glucose determinations concurrently at bedside and in the laboratory) is difficult to perform. It also raises questions about the responsibility of "point-of-care testing", an area still subject to discussion.