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Inaccurate Glucose Sensor Values After Hydroxyurea Administration.

Siobhan E Tellez1, Lindsey N Hornung2, Joshua D Courter3

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Diabetes Technology & Therapeutics
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Summary

Hydroxyurea (HU) medication significantly elevates continuous glucose monitoring (CGM) sensor readings, causing discrepancies with glucometer values for up to 6 hours. Patients using CGM with HU therapy should rely on glucometers for accurate glucose monitoring during this period.

Keywords:
Continuous glucose monitoringDiabetesPediatricsPharmacologyTPIAT

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Medical Devices

Background:

  • Continuous glucose monitoring (CGM) systems are vital for diabetes management.
  • Hydroxyurea (HU) is a medication with potential effects on glucose metabolism.
  • Understanding drug-device interactions is crucial for patient safety and accurate data.

Purpose of the Study:

  • To evaluate the impact of hydroxyurea (HU) on the accuracy of continuous glucose monitoring (CGM) systems.
  • To assess the magnitude, duration, and error patterns of glucose readings discrepancies after HU administration.
  • To compare the performance of Dexcom G4 and G6 CGM systems in the presence of HU.

Main Methods:

  • Analysis of inpatient glucometer and CGM data from patients receiving daily hydroxyurea (HU) doses.
  • Comparison of Dexcom Professional G4 (n=16) and Dexcom G6 (n=12) CGM readings against glucometer values.
  • Assessment of glucose discrepancies at various time points (0.5-6 hours) post-HU administration.

Main Results:

  • A significant positive elevation in CGM sensor readings compared to glucometer values was observed after HU administration.
  • The largest discrepancies occurred 0.5-2 hours post-HU, with Mean Absolute Relative Differences (MARD) up to 91% for G6 and 55% for G4.
  • Glucose readings normalized, with MARD below 17% and 94% of pairs in acceptable range by 6-9 hours post-HU for G6.

Conclusions:

  • Hydroxyurea (HU) administration causes a marked, temporary elevation in Dexcom CGM sensor glucose readings.
  • Patients on HU therapy should be advised to use glucometers for accurate glucose assessment for 6-9 hours after HU dosing.
  • Further research may be needed to understand the mechanism of HU interference with CGM technology.