Accuracy of blood glucose measurements using capillary and arterial line of extracorporeal circuit of hemodialysis among diabetic patients undergoing outpatient hemodialysis at The Medical City
- Author:
Genevieve F. Sia
1
;
Christy S. Yao
1
Author Information
- Publication Type:Journal Article
- Keywords: Accuracy; Capillary blood glucose; Point of care glucose meter
- MeSH: Vascular Access Devices; Renal Dialysis
- From: Philippine Journal of Internal Medicine 2017;55(4):1-5
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Accurate and reliable glucose level
measurements are essential for ensuring safe and effective
glycemic control among diabetic patients undergoing
hemodialysis (HD). Capillary blood glucose (CBG) monitoring
is the standard of care of glycemic control assessment in
patients with diabetes on maintenance HD. In the Philippines,
glucose monitoring during HD involves either standard finger
stick (CBG) or blood sample from the arterial line (AL) of
extracorporeal circuit of HD machine. However, anecdotal
observations noted over the years have shown discrepancies
in the glucose values from the two sites. This study aimed to
determine the accuracy of blood glucose measurements
of capillary and AL of extracorporeal circuit of HD machine
using point-of-care (POC) glucose meter in comparison to
central laboratory venous plasma among diabetic patients
undergoing outpatient HD in a private tertiary hospital in
the Philippines. Determining the most accurate and reliable
method of glucose level measurement is vital in helping
patients attain glycemic control. To date, there is limited
published data regarding the accuracy of blood glucose
values obtained through CBG and AL of extracorporeal
circuit of HD machine while patients are undergoing dialysis.
Methods:This is a prospective, cross-sectional, analytical study involving thirty patients. Forty blood samples from 30 patients obtained through CBG, AL and the peripheral venous plasma of the opposite arm were simultaneously analyzed. Specifically, StatStrip was utilized as the POC glucose meter. Accuracy of AL of extracorporeal circuit and CBG were determined and assessed in accordance with International Organization for Standardization (ISO) 15197:2013 minimum accuracy criteria for glucose meters. Regression analysis was used to determine whether AL and CBG significantly predict peripheral venous blood glucose levels.
Results:Analysis showed that there is a statistically significant difference in the glucose values obtained from AL and CBG (p-values 0.005 and <0.0001) when compared to venous plasma glucose. However, this may not pose clinical significance in routine practice. It is noteworthy that both AL (concordance rate (CR)=100%) and CBG (CR=96.5%) satisfied the revised ISO 15197:2013 accuracy criteria for glucose value greater than or equal to 100mg/dL.
Conclusion:Both CBG and AL blood glucose measurement significantly predict venous plasma blood glucose level. POC blood glucose value from both AL of extracorporeal circuit during HD and CBG satisfied the accuracy criteria set by ISO 15197: 2013 for glucose value greater than or equal to 100mg/dL. Thus, confirming the glucose level by CBG monitoring is not necessary in patients with arterial glucose value of greater than or equal to 100 mg/dL during HD. - Full text:PJIM 44.pdf
