Thirty drugs used primarily in critical care and hospital settings were tested in vitro to observe interference on glucose measurements with 6 hand-held glucose meters and a portable glucose analyzer. Paired differences of glucose measurements between drug-spiked samples and unspiked control samples were calculated to determine bias. A criterion of +/- 6 mg/dL was used as the cutoff for interference. Ascorbic acid interfered with the measurements on all glucose devices evaluated. Acetaminophen, dopamine, and mannitol interfered with glucose measurements on some devices. Dose-response relationships help assessment of drug interference in clinical use. High dosages of these drugs may be given to critically ill patients or self-administered by patients without medical supervision. Package inserts for the glucose devices may not provide adequate warning information. Hence, we recommend that clinicians choose glucose devices carefully and interpret results cautiously when glucose measurements are performed during or after drug interventions.
Description In our tests, one hand held glucose measurement device (Accu-Chek Performa, Roche, Germany) and one handheld accute analyzer (Chemstrip A-terminator, Roche, Germany) provided accurate and precise measurements. Glucose measurements by the HemoCue and BTS meters were not precise or accurate and produced large measurement errors. Using 5 clinical levels of glucose, we spiked samples with acetaminophen, dopamine, and mannitol as well as ascorbic acid and missed drugs (glucose oxidase inhibitor) to evaluate ability to detect interference. Despite the fact that interference occurred, it was difficult to detect which drug was interfering with the results on these meters.
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