Accu-Chek Performa Research Articles

Impact of hematocrit levels on the accuracy of specific blood glucose meters: Ahospital-based study.

Blood glucose meters are commonly used at the bedside, but most of the meters used in Hung Vuong Hospital (Ho Chi Minh City, Vietnam) are built for self-monitoring and might not be suitable for determining glucose levels in patients. In this study, we aimed to validate the performance of six frequently used meters in our hospital using the Clinical & Laboratory Standards Institute (CLSI) standard, and investigate the hematocrit impact on the accuracy of these meters. A total of 135 pregnant women who underwent a 75-g oral glucose tolerance test consented to participate in the study at Hung Vuong Hospital. Whole blood glucose levels were measured in duplicate using meters, and hematocrit levels were measured using an Alinity h-series analyzer. Within 5 min, plasma glucose levels were measured twice in a row using the Cobas c502 reference analyzer. For accuracy and precision, the hematocrit effect was assed using CLSI POCT12-A3. Out of six evaluated meters, three meters qualified. For CLSI criterion at glucose concentration of 5.55 mmol/L, Accu-Chek Inform II, Accu-Chek Performa and OneTouch VerioVue achieved 97.31%, 98.08% and 99.62%, respectively. For CLSI criterion at 4.17 mmol/L, these three achieved 100%. Accu-Chek Inform II and Accu-Chek Performa showed an inverse correlation between glucose level and hematocrit with slopes of -0.500 (95% confidence interval -0.678 to -0.322) and -0.396 (95% confidence interval -0.569 to -0.224), whereas OneTouch VerioVue was not affected by hematocrit, with a slope of 0.207 (95% confidence interval -0.026 to 0.440). Blood glucose meters' measurements can be affected by hematocrit, and might provide readings not within an acceptable bias. Medical organizations need to verify or validate before using on patients.

Assessing Elevated Blood Glucose Levels Through Blood Glucose Evaluation and Monitoring Using Machine Learning and Wearable Photoplethysmography Sensors: Algorithm Development and Validation.

Diabetes mellitus is the most challenging and fastest-growing global public health concern. Approximately 10.5% of the global adult population is affected by diabetes, and almost half of them are undiagnosed. The growing at-risk population exacerbates the shortage of health resources, with an estimated 10.6% and 6.2% of adults worldwide having impaired glucose tolerance and impaired fasting glycemia, respectively. All current diabetes screening methods are invasive and opportunistic and must be conducted in a hospital or laboratory by trained professionals. At-risk participants might remain undetected for years and miss the precious time window for early intervention to prevent or delay the onset of diabetes and its complications. We aimed to develop an artificial intelligence solution to recognize elevated blood glucose levels (≥7.8 mmol/L) noninvasively and evaluate diabetic risk based on repeated measurements. This study was conducted at KK Women's and Children's Hospital in Singapore, and 500 participants were recruited (mean age 38.73, SD 10.61 years; mean BMI 24.4, SD 5.1 kg/m2). The blood glucose levels for most participants were measured before and after consuming 75 g of sugary drinks using both a conventional glucometer (Accu-Chek Performa) and a wrist-worn wearable. The results obtained from the glucometer were used as ground-truth measurements. We performed extensive feature engineering on photoplethysmography (PPG) sensor data and identified features that were sensitive to glucose changes. These selected features were further analyzed using an explainable artificial intelligence approach to understand their contribution to our predictions. Multiple machine learning models were trained and assessed with 10-fold cross-validation, using participant demographic data and critical features extracted from PPG measurements as predictors. A support vector machine with a radial basis function kernel had the best detection performance, with an average accuracy of 84.7%, a sensitivity of 81.05%, a specificity of 88.3%, a precision of 87.51%, a geometric mean of 84.54%, and F score of 84.03%. Our findings suggest that PPG measurements can be used to identify participants with elevated blood glucose measurements and assist in the screening of participants for diabetes risk.

Application of Accu-Chek® Test Strips as inexpensive microelectrodes for BIA research

In the midst of an investigation to perform bioelectrical impedance analysis (BIA), we were faced with the need to search for optimally adjusted electrodes to perform reading in small biological samples. The best option to carry out these readings is the well-known gold microelectrodes; however, these are very expensive for our research purposes. For this reason, we found an alternative using Accu-Chek Performa test strips as reading microelectrodes due to their low cost and ease of disposal. This article contains an in-depth detail of the components of the Accu-Chek Performa test strip and the process that was used so that they could be suitable for taking measurements on biological material. In addition, a measurement scheme is shown in conclusion to the operation of the test strip as a microelectrode and the possible problems to consider if it is to be used for future research.

Glycemic status of infants of diabetic mothers; a study at the Children’s Hospital and Institute of Child Health, Multan.

Objective: To find out the frequency of hypoglycemia among infants of diabetic mothers (IDMs) and factors affecting it. Study Design: Descriptive Cross Sectional study. Setting: Department of Neonatology, The Children’s Hospital and Institute of Child Health, Multan, Pakistan. Period: September 2019 t0 June 2020. Material & Methods: A total of 186 IDMs admitted to department of neonatology during the study period were enrolled. Bed side blood glucose (BG) was measured using “Accu Chek Performa Blood Glucose Meter” at 0, 2, 4, 6, 8, 12, 18 and 24 hours of life. All IDMs (Infants of Diabetic Mothers) were labeled either gestational diabetes mellitus (GDM) or pre GDM (pre-GDM). IDMs noted to have hypoglycemia during 1st 24 hours of life were described as hypoglycemic and others were labeled as normoglycemic IDMs. Results: Hypoglycemia was noted among 77 (41.4%) IDMs. Duration of disease was significantly more among mothers of hypoglycemic infants (27.62+28.8months vs. 19.69+24.41 months, p=0.0444). Significantly more large for gestational age (LGA) IDMs were found to be hypoglycemic in comparison to normoglycaemic ones (32.5% vs. 16.5%, p=0.0110). Among a total of 77 IDMs noted to have hypoglycemia, 34 (44.1%) were born to mothers who had GDM while remaining 43 (55.9%) were born to pre-GDM mothers. Significantly more IDMs were preterm among pre-GDM mothers when compared to GDM mothers (53.5% vs. 23.5%, p=0.0077). Conclusion: Hypoglycemia is frequent problem among IDMs. Increased duration of diabetes among mothers, LGA as well as preterm IDMs are found to have significantly increased risk of developing hypoglycemia.

The Evaluation of Fasting Plasma Glucose (FPG) Levels in Hypertensive Patients Using Calcium Channel Blocker (CCB) Drugs Class in Undata Regional Hospital

Background: Hypertension plays a major role in the development of heart disease which is one of the most leading causes of death worldwide. Antihypertensives must be selected carefully to avoid affecting metabolic parameters. A risky case involving the increase of plasma glucose levels using Calcium Channel Blocker (CCB) antihypertensive, amlodipine, has been reported. Objectives: This study aims to examine the effects of CCB treatments on blood glucose levels in hypertensive patients at the Undata District General Hospital of Central Sulawesi Province. Material and Methods: This study used a cross-sectional design with a prospective approach. The instruments & materials used in this study are Accu-Chek Performa glucometer along with the patient's blood sample material. The research subjects were 31 patients who met the inclusion criteria; patients had been treated with CCB therapy for 3 months, patients were not diagnosed with diabetes mellitus, andpatients did not use drugs that might affect the blood glucose levels. Results: The results showed an average value of fasting plasma glucose (FPG) levels of hypertension patients using CCB class showed an increase from baseline of 124,619 mg/dL to 141,612 mg/dL with a difference of 16,993 mg/dL. Statistical analysis conducted also obtained a significance value of p 0,000 which indicates that the use of amlodipine can significantly increase fasting patients' plasma glucose levels. Conclusions: If observed clinically, the increasing in fasting plasma glucose values ​​falls into the category of mild to moderate hyperglycemic.

Comparative evaluation between two portable glucometers and the enzymatic colorimetric laboratory method in glycemic dosage in horses

In the equine clinic, the reference system for measuring blood glucose is the colorimetric enzymatic laboratory method. However, equipment, specific reagent and more time are required to perform it. Due to practicality, portable glucometers have been gaining ground in veterinary medicine, providing the result quickly, facilitating the measurement of blood glucose in the field. Several studies have used portable glucometers to measure blood glucose in horses, however, there are still many controversies about the reliability of their results compared to the enzymatic method. Therefore, the objective of this work was to evaluate the use of two portable glucometers for the measurement of blood glucose in horses considering the conventional laboratory test as control. For this purpose, the Wellion GLUCO CALEA® portable veterinary glucometer and the ACCU-CHEK Performa® human portable glucometer were evaluated and compared with the colorimetric enzymatic test. It was concluded that the ACCU-CHEK Performa® glucometer can be used for rapid blood glucose tests in horses.

Comparing the effect of ladies’ finger water with fenugreek seeds water on the blood glucose level among subjects with type 2 diabetes mellitus-a randomized controlled trial

<p><strong>Background: </strong>The primary aim of managing diabetes is to maintain blood glucose level to prevent diabetes induced complications. Studies showed that ladies finger and fenugreek seeds are blood sugar stabilizer. The objective of this randomized active controlled trial was to assess the effect of ladies finger water versus fenugreek seeds water on the blood glucose level among subject with type 2 diabetes.</p><p><strong>Methods: </strong>Total of 180 study participants were selected and equally assigned to three groups by computer generated randomization. Group 1-received ladies finger water and oral antidiabetic drug (OAD); group 2-received fenugreek seeds water and OAD; group 3-received only OAD for 15 days. Pre and post intervention fasting blood sugar (FBS) was assessed by accu-chek Performa glucometer. Wilcoxon signed rank test; one-way analysis of covariance followed by post hoc test with Bon-ferroni correction was done.</p><p><strong>Results: </strong>Analysis was done based on 168 subjects. There was a significant reduction in FBS level with the mean difference of group 1-21.0 mg/dl (p<0.001), group 2-20.3 mg/dl (p<0.001) and group 3-4.7 mg/dl (p=0.068). No significant difference found between group 1 and group 2 (p=1.00), but significant difference found between group 1 and group 3 (p=0.032); group 2 and group 3 (p=0.012). Both ladies finger water and fenugreek seeds water were superior in reduction of FBS than OAD.</p><p><strong>Conclusions: </strong>Ladies finger water or fenugreek seeds water can be used as adjunct along with OAD to control type 2 diabetes mellitus.</p><p><strong> </strong></p>

Maternal high-fructose intake during pregnancy and lactation induces metabolic syndrome in adult offspring.

BACKGROUND/OBJECTIVESNutritional status and food intake during pregnancy and lactation can affect fetal programming. In the current metabolic syndrome epidemic, high-fructose diets have been strongly implicated. This study investigated the effect of maternal high-fructose intake during pregnancy and lactation on the development of metabolic syndrome in adult offspring.SUBJECTS/METHODSDrinking water with or without 20% fructose was administered to female C57BL/6J mice over the course of their pregnancy and lactation periods. After weaning, pups ate regular chow. Accu-Chek Performa was used to measure glucose levels, and a tail-cuff method was used to examine systolic blood pressure. Animals were sacrificed at 7 months, their livers were excised, and sections were stained with Oil Red O and hematoxylin and eosin (H&E) staining. Kidneys were collected for gene expression analysis using quantitative real-time Polymerase chain reaction.RESULTSAdult offspring exposed to maternal high-fructose intake during pregnancy and lactation presented with heavier body weights, fattier livers, and broader areas under the curve in glucose tolerance test values than control offspring. Serum levels of alanine aminotransferase, aspartate aminotransferase, glucose, triglycerides, and total cholesterol and systolic blood pressure in the maternal high-fructose group were higher than that in controls. However, there were no significant differences in mRNA expressions of renin-angiotensin-aldosterone system genes and sodium transporter genes.CONCLUSIONSThese results suggest that maternal high-fructose intake during pregnancy and lactation induces metabolic syndrome with hyperglycemia, hypertension, and dyslipidemia in adult offspring.

Accuracy Evaluation of Five Blood Glucose Monitoring Systems in Patients from Different Departments

Self-monitoring of blood glucose (SMBG) systems are expected to be accurate and provide reliable results. The international standard ISO (International Organization for Standardization) 15197:2013 is widely accepted for the accuracy evaluation for SMBG systems. Accuracy evaluation was performed for 5 different SMBG systems in patients from multi-departments at the hospital. A total of 120 patients from Changzhou Second People's Hospital (Changzhou, China) were randomized and enrolled in the study. Accuracy evaluation was performed for 5 different SMBG systems: Gold AQ (Sinocare), Freestyle Optium Xceed (Abbott), Contour TS (Bayer), OneTouch Ultra (J&J) and Accu-Chek Performa (Roche). For each system, comparison measurements were performed with YSI 2300 STAT PLUS Glucose and Lactate Analyzer and Roche Cobas 8000 Modular Analyzer. All 5 systems showed that 100% of results fall within consensus error grid Zones A and B. Compared with YSI 2300 or Roche Cobas 8000 Modular Analyzer, Gold AQ system showed the highest accuracy. The linearity analysis also showed that Gold AQ had the highest correlation coefficient. Compared with other SMBG systems, Gold AQ Glucose Monitoring System manufactured by Sinocare Inc. had the highest accuracy in measuring blood glucose level in patients from multi-departments at this hospital.

The accuracy evaluation of four blood glucose monitoring systems according to ISO 15197:2003 and ISO 15197:2013 criteria

Self-monitoring of blood glucose is recommended to monitor glycaemic levels for the prevention and treatment of diabetes mellitus.The accuracy of blood glucose monitoring systems (BGMS) directly affects the health of the patients. In this study, we evaluated the accuracy of four different blood glucose monitoring systems, including Gold-Accu Meter, Nova StatStrip Xpress® Glucose Hospital Meter, Freestyle Optium Neo H® and Accu-Chek Performa according to ISO15197:2003 and ISO15197:2013 criteria. We found that four brands of BGMS (eight BGMS) all met the minimum requirements for system accuracy performance of ISO 15197:2003 and the accuracy criteria of ISO 15197:2013. All results of BGMS lie within zones A and B of the Consensus Error Grid (CEG). In conclusion, all BGMS met the accuracy criteria of ISO 15197:2003 and the accuracy criteria of ISO 15197:2013.

Normal Point of Care Glucose Values after Birth in the Well-Baby Nursery.

Normal initial blood glucose values in healthy newborns are not well defined and are subject to controversy. Despite substantive research, there is no single initial value of glucose that can be used with certainty of safety in newborns, and thus various protocols and cutoffs have been proposed. We sought to characterize the normal values of blood glucose levels in a large cohort of neonates admitted to the well-baby nursery in Shaare Zedek Medical Center. The blood glucose levels were measured with a point of care (POC) glucometer (Accu-Chek Performa) within 180 minutes after birth. The study population included 3,912 newborns with a mean birth weight of 3,322 ± 439 g and a mean gestational age of 39.4 ± 1.3 weeks. Sampling was performed at a median age of 73 minutes (interquartile range [IQR], 55-92 minutes). Median glucose concentration was 58 (IQR, 51-67) mg/dL, and first, third, and fifth percentiles were 34, 39, and 41 mg/dL, respectively. Our data describe the normal range of POC blood glucose levels in healthy neonates on admission to the nursery. Extreme low levels were rare.

UJI GLUKOSA DARAH ANTARA METODE HEKSOKINASE DENGAN GLUKOSA OKSIDASE DAN GLUKOSA DEHIDROGENASE DI DIABETES MELITUS

Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia that occurs because of abnormalities insulinsecretion, insulin or both. Diabetes mellitus diagnosis is established on the basis of examination of blood glucose levels. The recommendedblood glucose test is enzymatic method by hexokinase using venous blood plasma, while for monitoring the outcomes of treatment: bloodglucose test can be done by rapid test using capillary blood. The purpose of this study was to know the test result of blood glucose betweenhexokinase method (ABX Pentra 400), glucose oxidase (StatStrip Xpress, Super Glucocard II) and glucose dehydrogenase methods(Accu-Chek Performa) by comparing them Cross sectional study was conducted on 50 samples of patient hospitalized at Dr. WahidinSudirohusodo Hospital Makassar. The blood glucose test were performed at the Departement of Clinical Pathology from June up to July2012. Each plasma sample was tested using ABX Pentra 400, StatStrip Xpress, Super Glucocard II and Accu-Chek Performa. The datawere analyzed using Kolmogorov Smirnov and Mann Whitney test. Based from this study was showed that there was no difference in bloodthe level using a related (glucose) oxidase (StatStrip Xpress, Super Glucocard II) and its dehydrogenase method (Accu-Chek Performa)compared with hexokinase method (ABX Pentra 400) with p value > 0.05. The result obtained in this study showed that StatStrip Xpress,Super Glucocard II and Accu-Chek Performa can be used as a rapid test for monitoring blood glucose in hospitalized patients.

Fiabilité de la mesure de la glycémie capillaire par rapport à la glycémie plasmatique chez le nouveau-né

The reliability of blood glucose monitoring in neonatology is not always confirmed. The aim of this study was to evaluate the reliability of blood glucose measurements made with three different devices in newborns. The study was prospective, conducted in a medical and neonatal intensive care department over a period of 4 months. Capillary glucose level was measured with three different glucometers and compared with venous glucose level determined using the hexokinase method. An ANOVA and Scheffe test were used for the correlation analysis. Three hundred and nine infants were included, with a mean age of 55h and a mean term of 39weeks of gestation. Mean blood glucose in the laboratory was 0.62±0.15g/L, 0.71±0.17g/L for Accu-Chek(®) Active, 0.80±0.17g/L for Accu-Chek(®) Performa, and 0.83±0.12g/L for Bionime. An ANOVA showed statistically significant differences between the measurements made by glucometers compared to the reference blood glucose levels, and the Scheffé method showed that glucometers overestimated the real plasma glucose levels. None of the devices used in this study was satisfactory. However, an estimation of blood glucose taking into consideration this numerical overestimation would allow early detection of hypoglycemia.

Analytical performance of glucometers in a tertiary care hospital

Point-of-care (POC) testing of glucose (glucometers) represents a convenient alternative to monitor glycemia since the measurement procedure is performed without delay after sampling of the capillary blood, thereby avoiding the metabolism by the blood cells of glucose present in plasma. Likely because of sample instability, there is no proficiency test provider in Brazil for this type of POC sample. In this context, this study aimed to evaluate the analytical performance of glucometers used in a tertiary care hospital. The glucometers used were the Accu-Chek Performa® model from Roche Diagnostics, which use the principle of amperometry. The reference method was the reaction with modified hexokinase/glucose-6-phosphate in a Dimension® device. The stability evaluation of the control samples showed that it can be performed up to 90 min after the collection of whole blood samples. In the two rounds performed, only one result of the 17 glucometers evaluated was out of the threshold of two standard deviation. Thus, this method for control of glucometers met the expectations and enabled comparing the glucometers in a hospital. Given the current quality guidelines, daily internal quality control of glucometers is recommended, besides at least two annual comparisons between the results of the glucometers and the reference method and one EQA every 3 months.

Accuracy Evaluation of CONTOUR(®)PLUS Compared With Four Blood Glucose Monitoring Systems.

IntroductionThe aim of this study was to compare the accuracy of 5 blood glucose monitoring systems (BGMSs; CONTOUR®PLUS [CP], Accu-Chek® Active [ACA], Accu-Chek® Performa [ACP], FreeStyle Freedom™ [FF], OneTouch® SelectSimple™ [OTSS]).MethodsStudy staff tested fingerstick samples from 106 subjects aged ≥18 years using the 5 BGMSs. Some samples were modified to achieve blood glucose concentrations throughout the measuring range. The primary endpoint was comparison of the mean absolute relative difference (MARD) from the reference value (Yellow Springs Instruments [YSI]) across the overall tested glucose range. Other endpoints were MARD in the low (≤80 mg/dL [≤4.4 mmol/L]), middle (81–180 mg/dL [4.5–10.0 mmol/L]), and high (>180 mg/dL [>10.0 mmol/L]) glucose ranges, and MARD for unmodified samples in the overall glucose range.ResultsCONTOUR®PLUS had a statistically significantly lower MARD than all BGMSs across the overall tested range (27–460 mg/dL [1.5–25.5 mmol/L]) and in the high glucose range. In the low glucose range, CP had a lower MARD than all BGMSs, which was statistically significant except for ACP. For unmodified samples across the overall tested range, CP had a lower MARD than all BGMSs and was statistically significantly lower except for ACA.ConclusionsCONTOUR®PLUS had the lowest mean difference from the reference values (by MARD) when compared with other BGMSs across multiple glucose ranges with modified and unmodified samples.FundingBayer HealthCare LLC, Diabetes Care.Trial registration number: ClinicalTrials.gov Identifier NCT01714232.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-015-0121-3) contains supplementary material, which is available to authorized users.

Evaluation of hematocrit interference with MyStar extra and seven competitive devices.

In previous studies, meters employing dynamic electrochemistry (DE), have been shown to correct for hematocrit (HCT) interference. This laboratory investigation assessed the HCT stability of MyStar Extra (Sanofi) in comparison to 7 competitive devices (Accu-Chek Aviva Nano & Accu-Chek Performa, Roche Diagnostics; Contour XT and Contour Link, Bayer; FreeStyle Freedom Lite, Abbott; MyLife Pura, Ypsomed; OneTouch Verio Pro, LifeScan). Venous heparinized blood was freshly drawn, immediately aliquoted, and manipulated to contain 3 different blood glucose concentrations (50-80 mg/dL, 150-180 mg/dL, and 350-400 mg/dL) and 5 different HCT levels (20-25%, 30-35%, 40-45%, 50-55%, and 60-65%). After careful oxygenation to normal blood oxygen pressure, each of the 15 different samples was measured 8 times with 2 devices and 2 strip lots of each meter (32 measurements/meter/sample). YSI Stat 2300 served as laboratory reference method. Next to determination of the mean absolute relative deviation (MARD), stability to HCT influence was assumed, when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT over all tested glucose ranges (HIF: hematocrit interference factor). Four of the devices showed stable performance: Contour XT (MARD: 1.3%/HIF: 6.1%), MyStar Extra (4.7%/7.1%), OneTouch Verio Pro (4.5%/7.3%), and Contour Link (6.3%/9.3%). The 4 other meters were influenced by HCT (Accu-Chek Performa: 4.7%/20.9%, Accu-Chek Aviva Nano: 4.5%/22.4%, FreeStyle Freedom Lite: 4.8%/24.5%; MyLife Pura: 6.4%/28.7%). In this study, all meters showed a good accuracy, but only 50% of them, including MyStar Extra, were shown to reliably correct for potential hematocrit influence on the meter results.

Cinnamon has Higher Efficacy in Attenuating Postprandial Hyperglycemia in Healthy Subjects When Taken After Intake of Glucose

Cinnamon's potential efficacy in regulating hyperglycemia has been gaining interest. Evidence from animal studies proves its efficacy as an insulin mimetic and insulin-sensitizing agent. Other studies on humans reported that this spice lowers fasting blood glucose after several weeks of consumption. This study investigated the ability of cinnamon to attenuate postprandial hyperglycemia and whether time of ingestion is a determining factor of its efficacy in normal subjects. The study was approved by the university ethical committee. Thirty healthy subjects fasted for 10–12 hours prior to each experiment of the study and each of this experiment has a 1-week washout period. For the control (C) experiment, the subjects were given 75 g of D-(+)-glucose monohydrate alone, whereas for the treatment experiments subjects were given 6 g of cinnamon at different times such as 30 minutes before (B), 30 minutes after (A) ingestion of glucose and simultaneously (S) given with glucose. At 0, 30, 60, 90 and 120 minutes after treatment blood sample was taken then measured its glucose content using Accu-chek Performa®. The total iAUC (±SEM) measured are as follows: C (17,262±351), B (15,592±345), A (13,025±305) and S (14,668±460). One-way ANOVA test was used to compare means of iAUC among the control and treatment groups and the significance of the difference of each pair is C-vs-B (p=.021), C-vs-S (p=.000), C-vs-A (p=.000), B-vs-S (p=.038), B-vs-A (p=.000), S-vs-A (p=.024). It is concluded that cinnamon significantly attenuates postprandial hyperglycemia and it has higher efficacy when taken 30 min after ingestion of glucose.

A discordant of blood glucose analysed by Glucometer and the Central lab method in an infant with Galactosemia

Galactosemia is an autosomal recessive disorder, which caused by a deficiency of one of three enzymes that involved in the metabolism of galactose; galactokinase (GALK), galactose-1-phosphate uridyltransferase (GALT) and uridine-diphosphate galactose-4'epimerase (GALE). Clinical manifestations including poor feeding, jaundice, hepatomegaly, vomiting, hypoglycemia, convulsions, failure to thrive, cataracts, bleeding disorder, renal failure, liver cirrhosis, mental retardation and increased risk for E. coli sepsis,develop after milk feeding. We reported an infant who presented with prolonged hyperbilirubinemia and different result of blood glucose between glucometer and the central lab which is an unusual presentation of galactosemia. A 11- day-old male infant born to non-consanguineous parents presented with jaundice, poor feeding, poor weight gain, vomiting and drowsiness when he was 6-day-old. On physical examination revealed lethargic, icteric sclerae and hepatomegaly. Cataract examined by the opththalomologist was not found. Routine work up for the causes of neonatal jaundice was found to be normal. LFTs showed TB of 26.8, DB 3.57 mg/dL, SGOT 82, SGPT 50 and ALP 871U/L. TFTs showed FT4 of 1.62 ng/dL, TSH 4.91 mu/L. Electrolytes and coagulogram were normal. His blood sugar was 220 mg/dL by Glucometer (Accu-chek Performa) without any symptoms and signs of hyperglycemia and glucosuria, but it was 60 mg/dL by the central lab method. Galactosemia was confirmed by the high level of urine Galactitol and the genetic analysis of Galactose-1-phosphate uridyl transferase (GALT) found compound heterozygous mutation of p.R259W in exon 8 and p.E340K in exon 10 which is a known mutation. One day after soy-based formula was started, the bilirubin levels were gradually reduced to normal for 1 week and the discrepancy of blood glucose between Glucometer and the central lab method was resolved. Sepsis can not be totally excluded by this clinical setting, antibiotic was started to cover the organism which is common for this age group including E Coli. This paper reported infant with Galactosemia who presented with an unusual finding of the discordance between blood sugar levels analysed by Glucometer and the central lab method due to some Glucometer analyse other form of sugar especially Galactose and its metabolites.

Impact of prandial status on the comparison of capillary glucose meter and venous plasma glucose measurements in healthy volunteers

There is a negative glucose gradient between the capillary and venous systems, produced by glucose uptake into peripheral tissues. This gradient is augmented by oral glucose ingestion in healthy volunteers; thus prandial status may impact on capillary glucose meter performance. Our primary aim was to investigate whether the (capillary-venous plasma) glucose difference changed in relation to prandial status, in healthy volunteers. Glucose was measured fasting and also one hour after an ad libitum breakfast, in 103 healthy volunteers. Duplicate capillary (finger stick) measurements were undertaken at both time points, using both the FreeStyle Lite and AccuChek Performa meters. Simultaneous venous (antecubital fossa) samples were centrifuged immediately after collection and plasma glucose was measured using the laboratory hexokinase method. Results were compared by Bland-Altman difference analysis. The mean (95% CI) pre- and postprandial (capillary-plasma) glucose differences (mmol/L) were calculated for each meter. For the Freestyle Lite, the preprandial difference was -0.51 (-0.58 to -0.45) and postprandial difference was 0.81 (0.69-0.94). Corresponding differences for the Performa were -0.13 (-0.20 to -0.06) and 1.19 (1.07-1.31), respectively. T-test comparison of participants' paired pre- and postprandial (capillary-plasma) glucose differences confirmed a significant meal-related change in glucose estimation for both meters (P < 0.0001). Also, both meters read highest at lower glucose concentrations. In healthy volunteers, both glucose meters showed a systematic positive bias one hour after breakfast. The significance of this finding in diabetes remains to be determined.

Tighter Accuracy Standards within Point-of-Care Blood Glucose Monitoring: How Six Commonly Used Systems Compare

Blood glucose monitoring systems (BGMS) are used in the hospital environment to manage blood glucose levels in patients at the bedside. The International Organization for Standardization (ISO) 15197:2003 standard is currently used by regulatory bodies as a minimum requirement for the performance of BGMS, specific to self-testing. There are calls for the tightening of accuracy requirements and implementation of a standard specifically for point-of-care (POC) BGMS. The accuracy of six commonly used BGMS was assessed in a clinical setting, with 108 patients' finger stick capillary samples. Using the accuracy criteria from the existing standard and a range of tightened accuracy criteria, system performance was compared. Other contributors to system performance have been measured, including hematocrit sensitivity and meter error rates encountered in the clinical setting. Five of the six BGMS evaluated met current accuracy criteria within the ISO 15197 standard. Only the Optium Xceed system had >95% of all readings within a tightened criteria of ±12.5% from the reference at glucose levels ≥72 mg/dl (4 mmol/liter) and ±9 mg/dl (0.5 mmol/liter) at glucose levels <72 mg/dl (4 mmol/liter). The Nova StatStrip Xpress had the greatest number of error messages observed; Optium Xceed the least. OneTouch Ultra2, Nova StatStrip Xpress, Accu-Chek Performa, and Contour TS products were all significantly influenced by blood hematocrit levels. From evidence obtained during this clinical evaluation, the Optium Xceed system is most likely to meet future anticipated accuracy standards for POC BGMS. In this clinical study, the results demonstrated the Optium Xceed product to have the highest level of accuracy, to have the lowest occurrence of error messages, and to be least influenced by blood hematocrit levels.