Pourbiax Diagrams as an Aid to Understanding the Impact of Acid/Base Disturbance on Blood Glucose Point-of-Care Testing

Assays based on redox reactions that involve proton transfer are vulnerable to artifactual findings in metabolic acidosis/alkalosis. We evaluated the impact of pH on the measurement of blood glucose by the glucose dehydrogenase/pyrroloquinoline quinone system used in point-of-care-testing.

We applied a series of thermodynamic equations to adjust the Gibbs energy for the pyrroloquinoline quinone couple. This adjusts values taken under standard conditions to those more closely resembling the physiological state.

Under standard conditions, the pyrroloquinoline quinone couple has Eo = -0.125 V whereas adjustment to the physiological state (pH 7.40, ionic strength 0.15 mol/L, and temperature 310.15°K) yields Eo' = -0.166 V. This corresponds to an uncertainty in blood glucose determination of approximately 0.13 mmol/L.

We have demonstrated that the impact of pH on blood glucose determination by the glucose dehydrogenase/pyrroloquinoline quinone system (under physiologically relevant conditions of ionic strength and temperature) is not clinically significant.