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.
Vascular Access Devices ; Renal Dialysis