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Glucose meters: What's the laboratory reference glucose?
Mariarosa Carta1, Davide Giavarina1, Andreina Paternoster1
1St. Bortolo Hospital, Clinical Laboratory, Vicenza, Italy.
Journal of Medical Biochemistry
|June 19, 2020
Summary
Accurate glucose meter evaluation requires laboratory reference glucose analysis. Using citrate-containing tubes ensures reliable results, unlike those with only NaF, which can be affected by in vitro glycolysis.
Area of Science:
- Clinical Chemistry
- Biomedical Engineering
- Diabetes Diagnostics
Background:
- Glucose meter accuracy is critical for diabetes management and is typically assessed against laboratory reference analyzers.
- Scientific societies recommend glycolysis inhibitors like citrate for precise glucose measurements.
- In vitro glycolysis can occur in blood samples, potentially affecting glucose concentration readings.
Purpose of the Study:
- To evaluate the bias between capillary and plasma glucose measurements using different anticoagulant tubes.
- To assess the accuracy of glucose meters against laboratory reference methods under varying conditions.
- To determine the impact of NaF and citrate mixtures in blood collection tubes on glucose determination.
Main Methods:
- 139 volunteers undergoing oral glucose tolerance tests (OGTT) were enrolled.
- Capillary glucose was measured using two different glucose meters (Abbott FreeStyle Precision Neo, Roche Cobas Accu-Chek Inform II).
- Plasma glucose was analyzed using a hexokinase method on Dimension Vista systems, with samples collected in tubes containing NaF/citrate mixtures (liquid and granular) or NaF alone.
Main Results:
- When using liquid and granular citrate mixture tubes, 96.82% and 97.37% of capillary glucose determinations met specifications, respectively.
- In contrast, only 73.02% and 80.26% of determinations were within specifications when using tubes containing only NaF.
- These findings highlight a significant difference in accuracy based on the anticoagulant used.
Conclusions:
- Accurate evaluation of glucose meter accuracy necessitates understanding the laboratory reference glucose method.
- The use of blood collection tubes containing only NaF can lead to erroneous assessments of glucose meter accuracy due to in vitro glycolysis.
- Tubes incorporating citrate mixtures are essential for the correct evaluation of glucose meter accuracy, ensuring reliable diagnostic outcomes.
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