Rigorous glucose control is essential for prevention of diabetes-related complications in diabetes patients. Even without diabetes, tight glucose control is beneficial in hospitalized, critically ill patients.
Actually, three different glucose measurement methods are used: (1) hand held devices, (2) blood-gas analyzers, and (3) laboratory analyzers in core laboratories. Each method is subject to specific challenges and limitations that can affect the overall system performance.
In this article, we aim to demonstrate that even glucose measurement results from core laboratories (professional laboratory systems) do not necessarily reflect the absolute “true” glucose level of a patient.
HamburgMA. (Answer of the FDA to a letter of Garber JR from AACE on the performance of blood glucose testing meters). Personal communication. 2009.
5.
KlonoffDC. The Food and Drug Administration is now preparing to establish tighter performance requirements for blood glucose monitors. J Diabetes Sci Technol.2010;4 (3): 499–504.
6.
MaloneB. Higher standards on the way for glucose meters?Clin Lab News.2009;35 (9): 11.
7.
TonyushkinaKNicholsJH. Glucose meters: A review of technical challenges to obtaining accurate results. J Diabetes Sci Technol.2009;3 (4): 971–80.
8.
FreckmannGBaumstarkAJendrikeNZschornackEKocherSTshianangaJHeisterFHaugC. System accuracy evaluation of 27 blood glucose monitoring systems according to DIN EN ISO 15197. Diabetes Technol Ther.2010;12 (3): 221–31.
9.
TangZDuXLouieRFKostGJ. Effects of drugs on glucose measurements with handheld glucose meters and a portable glucose analyzer. Am J Clin Pathol.2000;113 (1): 75–86.
10.
PelletierOArratoonC. Precision of glucose measurements in control sera by isotope dilution/mass spectrometry: Proposed definitive method compared with a reference method. Clin Chem.1987;33 (8): 1397–402.
11.
ScassellatiG. Specific performance characteristics of in-vitro diagnostic medical devices. Biochim Clin2000;24: 493–7.
BretonMDKovatchevBP. Impact of blood glucose self-monitoring errors on glucose variability, risk for hypoglycemia, and average glucose control in type 1 diabetes: An in silico study. J Diabetes Sci Technol.2010;4 (3): 562–70.
TwomeyPJ. Plasma glucose measurement with the Yellow Springs Glucose 2300 STAT and the Olympus AU640. J Clin Pathol.2004;57 (7): 752–4.
22.
SacksDBBrunsDEGoldsteinDEMaclarenNKMcDonaldJMParrottM. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem.2002;48 (3): 436–72.
23.
HoedemaekersCWGunnewiekJM KleinPrinsenMAWillemsJLVan der HoevenJG. Accuracy of bedside glucose measurement from three glucometers in critically ill patients. Crit Care Med.2008;36 (11): 3062–6.
24.
VlasselaersDHerpeT VMilantsIEerdekensMWoutersPJMoorBDden BergheGV. Blood glucose measurements in arterial blood of intensive care unit patients submitted to tight glycemic control: Agreement between bedside tests. J Diabetes Sci Technol.2008;2 (6): 932–8.
25.
The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med.1993;329 (14): 977–86.
26.
UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet.1998;352 (9131): 837–53.
27.
StrattonIMAdlerAINeilHAMatthewsDRManleySECullCAHaddenDTurnerRCHolmanRR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. BMJ.2000;321 (7258): 405–12.
28.
NathanDMClearyPABacklundJYGenuthSMLachinJMOrchardTJRaskinPZinmanB; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med.2005;353 (25): 2643–53.
29.
HolmanRRPaulSKBethelMAMatthewsDRNeilHA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med.2008;59 (15): 1577–89.
30.
GaedePLund-AndersenHParvingHHPedersenO. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med.2008;358 (6): 580–91.
31.
CerielloA. The emerging role of post-prandial hyperglycaemic spikes in the pathogenesis of diabetic complications. Diabet Med.1998;15 (3): 188–93.
32.
CerielloA. The possible role of postprandial hyperglycaemia in the pathogenesis of diabetic complications. Diabetologia.2003;46Suppl 1: M9–16.
33.
GallagherAHomePD. The effect of improved post-prandial blood glucose control on post-prandial metabolism and markers of vascular risk in people with type 2 diabetes. Diabetes Res Clin Pract.2005;67 (3): 196–203.
34.
HanefeldMKoehlerCHenkelEFueckerKSchaperFTemelkova-KurktschievT. Post-challenge hyperglycaemia relates more strongly than fasting hyperglycaemia with carotid intima-media thickness: The RIAD Study. Risk Factors in Impaired Glucose Tolerance for Atherosclerosis and Diabetes. Diabet Med.2000;17 (12): 835–40.
35.
BonoraE. Postprandial peaks as a risk factor for cardiovascular disease: Epidemiological perspectives. Int J Clin PractSuppl.2002; (129): 5–11.
36.
Temelkova-KurktschievTSKoehlerCHenkelELeonhardtWFueckerKHanefeldM. Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level. Diabetes Care.2000;23 (12): 1830–4.
37.
DerrRGarrettEStacyGASaudekCD. Is HbA(1c) affected by glycemic instability?Diabetes Care.2003;26 (10): 2728–33.
38.
MonnierLColetteCDunseathGJOwensDR. The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes. Diabetes Care.2007;30 (2): 263–9.
39.
LandgrafR. The relationship of postprandial glucose to HbA1c. Diab Metab Res Rev.2004;20 (Suppl 2): S9–12.
40.
LeiterLACerielloADavidsonJAHanefeldMMonnierLOwensDRTajimaNTuomilehtoJ, International Prandial Glucose Regulation Study Group. Postprandial glucose regulation: New data and new implications. Clin Ther.2005;27Suppl B: S42–56.
41.
WeberCSchnellO. The assessment of glycemic variability and its impact on diabetes-related complications: An overview. Diabetes Technol Ther.2009;11 (10): 623–33.
42.
Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington R P, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med.2008;358 (24): 2545–59.
43.
ADVANCE Collaborative Group, PatelAMacMahonSChalmersJNealBBillotLWoodwardMMarreMCooperMGlasziouPGrobbeeDHametPHarrapSHellerSLiuLManciaGMogensenCEPanCPoulterNRodgersAWilliamsBBompointSde GalanBEJoshiRTravertF. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med.2008;358 (24): 2560–72.
44.
Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in the critically ill patients. N Engl J Med.2001;345 (19): 1359–67.
45.
BrunkhorstFMEngelCBloosFMeier-HellmannARagallerMWeilerNMoererOGruendlingMOppertMGrondSOlthoffDJaschinskiUJohnSRossaintRWelteTSchaeferMKernPKuhntEKiehntopfMHartogCNatansonCLoeffierMReinhartK, German Competence Network Sepsis (SepNet). Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med.2008;358 (2): 125–39.
46.
PreiserJCDevosP. Clinical experience with tight glucose control by intensive insulin therapy. Crit Care Med.2007;35 (9 Suppl): S503–7.
47.
NICE-SUGAR Study Investigators, FinferSChittockDRSuSYBlairDFosterDDhingraVBellomoRCookDDodekPHendersonWRHébertPCHeritierSHeylandDKMcArthurCMcDonaldEMitchellIMyburghJANortonRPotterJRobinsonBGRoncoJJ. Intensive versus conventional glucose control in critically ill patients. N Engl J Med.2009;360 (13): 1283–97.
48.
WienerRSWienerDCLarsonRJ. Benefits and risks of tight glucose control in critically ill adults: A meta-analysis. JAMA.2008;300 (8): 933–44.
49.
GriesdaleDEde SouzaRJvan DamRMHeylandDKCookDJMalhotraADhaliwalRHendersonWRChittockDRFinferSTalmorD. Intensive insulin therapy and mortality among critically ill patients: A meta-analysis including NICE-SUGAR study data. CMAJ.2009;180 (8): 821–7.
50.
ScottMGBrunsDEBoydJCSacksDB. Tight glucose control in the intensive care unit: Are glucose meters up to the task?Clin Chem.2009;55 (1): 18–20.
