N-Acetylcysteine Interference with a Glucose Dehydrogenase Linked Glucose Meter

Area of Science:

• Clinical Chemistry
• Biomedical Engineering
• Pharmacology

Background:

• N-acetylcysteine (NAC) is administered intravenously for various medical conditions.
• Accurate blood glucose monitoring is critical for patient management.
• Potential interferences with diagnostic assays require thorough investigation.

Purpose of the Study:

• To evaluate the impact of therapeutic N-acetylcysteine concentrations on blood glucose measurements.
• To compare results from a specific glucose meter against established laboratory methods.
• To identify potential biases introduced by N-acetylcysteine during glucose testing.

Main Methods:

• Blood samples were treated with varying concentrations of N-acetylcysteine.
• Glucose levels were measured using a Roche Diagnostics glucose meter (glucose dehydrogenase-linked).
• Comparative analyses were performed using a blood gas analyzer (glucose oxidase) and a hexokinase spectrophotometric method.

Main Results:

• N-acetylcysteine concentrations above 5 mg/dL led to statistically significant positive bias in glucose meter readings.
• Multivariate linear regression indicated that both NAC and glucose concentrations influence the meter's accuracy.
• The glucose dehydrogenase-linked meter showed notable discrepancies compared to laboratory standards in the presence of NAC.

Conclusions:

• Therapeutic concentrations of N-acetylcysteine can cause significant positive bias in blood glucose measurements using glucose dehydrogenase-linked meters.
• This interference may compromise the accuracy of point-of-care glucose testing in patients receiving NAC.
• Clinical laboratories and healthcare providers should be aware of this potential analytical interference.