Four methods for glucose assay compared for various glucose concentrations and under different clinical conditions

Glucose was measured by the ferricyanide, the Beckman glucose oxidase, and the hexokinase procedures in 228 plasma samples taken during standard oral glucose-tolerance tests in 17 normal subjects and in 21 chemical diabetics. The neocuproine method was also used to measure glucose concentration in 156 samples (78 before and 78 after dialysis) collected from six diabetic and uremic patients who were on maintenance hemodialysis. Ferricyanide in all conditions and neocuproine in uremic patients overestimated glucose concentrations over the entire experimental range as compared with either enzymic method. This bias or systematic error of the reducing vs the enzymic procedures, due to nonglucose reducing substances ("saccharoids"), becomes considerably greater when their concentration is increased as in chronic uremia. Also, the inverse relation between glucose concentration and overestimation of glucose by the reducing methods has been detected. With respect to the hexokinase method, a mild but significant underestimate of glucose oxidase readings has been observed for higher glucose concentrations. We find neocuproine to be the most imprecise of these procedures.