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DOI: 10.1055/s-2006-924011
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
Publication History
Received: August 15, 2005
First decision: November 11, 2005
Accepted: February 3, 2006
Publication Date:
25 April 2006 (online)
![](https://www.thieme-connect.de/media/eced/200603/lookinside/thumbnails/10.1055-s-2006-924011-1.jpg)
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.
Key words
Peritoneal dialysis - icodextrin - blood glucose
References
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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