Exp Clin Endocrinol Diabetes 2006; 114(3): 124-126
DOI: 10.1055/s-2006-924011
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Inaccurate Self-Monitoring of Blood Glucose Readings in Patients on Chronic Ambulatory Peritoneal Dialysis with Icodextrin

V. Pavlicek1 , 3 , D. Garzoni1 , 2 , P. Urech4 , M. Brändle1
  • 1Division of Endocrinology and Diabetes, Kantonsspital St. Gallen, St.Gallen, Switzerland
  • 2Division of Nephrology, University Hospital of Basel, Basel, Switzerland
  • 3Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital of Zürich, Zürich, Switzerland
  • 4Division of Nephrology, Kantonsspital St. Gallen, St.Gallen, Switzerland
Further Information

Publication History

Received: August 15, 2005 First decision: November 11, 2005

Accepted: February 3, 2006

Publication Date:
25 April 2006 (online)

Abstract

Patients on chronic ambulant peritoneal dialysis (CAPD) are increasingly likely to be treated with a new solution of corn starch-derived glucose polymers called icodextrin. This solution involves a very low carbohydrate absorption leading to a better glycemic control in diabetic patients. However these glucose polymers pass to the blood and are metabolized to oligosaccharids which interfere with blood glucose in distinct capillary glucose analyzers leading to overestimation of glycemia. We assessed the accuracy of glucose measurements with the three most commonly used glucose analyzers compared to venous plasma glucose measurement at our institution in 8 patients (4 patients with type 2 diabetes) on CAPD using icodextrin. Glycemia was measured simultaneously in plasma of venous blood using a reference laboratory method and in capillary blood using Accu-Chek sensor® (Rotkreuz, Switzerland) (glucose dehydrogenase method), Glucotrend 2® (Rotkreuz, Switzerland) (glucose-dye-oxyreductase method) and Ascensia elite® (Zurich, Switzerland) (glucose oxidase method) glucose analyzers. Only glucose readings with Ascensia elite® correspond correctly with venous plasma glucose results (+ 0.3 mmol/l; n. s.), whereas glycemia was significantly overestimated by Accu-Chek sensor® (+ 4.3 mmol/l; p < 0. 0001) and Glucotrend 2® glucose analyzers (+ 3.7 mmol/l; p < 0. 0001). Thus we conclude that distinct glucose analyzers overestimate real blood glucose concentration and are not suitable for monitoring glycemia in patients on CAPD with icodextrin. On the basis of our results, these patients should use glucose analyzers using glucose oxidase methods. All glucose analyzers should be cross-checked with a laboratory reference method before the application in patients on CAPD with icodextrin is recommended.

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M.D. Vojtech Pavlicek

Department of Internal Medicine
Division of Endocrinology and Diabetes
University Hospital of Zürich

8091 Zürich

Switzerland

Phone: + 4112551111

Fax: + 41 12 55 44 47

Email: vojtech.pavlicek@usz.ch