Literature DB >> 22920813

Effects of simulated altitude on blood glucose meter performance: implications for in-flight blood glucose monitoring.

Tolu Olateju1, Joseph Begley, Daniel Flanagan, David Kerr.   

Abstract

BACKGROUND: Most manufacturers of blood glucose monitoring equipment do not give advice regarding the use of their meters and strips onboard aircraft, and some airlines have blood glucose testing equipment in the aircraft cabin medical bag. Previous studies using older blood glucose meters (BGMs) have shown conflicting results on the performance of both glucose oxidase (GOX)- and glucose dehydrogenase (GDH)-based meters at high altitude. The aim of our study was to evaluate the performance of four new-generation BGMs at sea level and at a simulated altitude equivalent to that used in the cabin of commercial aircrafts. METHODOLOGY/PRINCIPAL
FINDINGS: Blood glucose measurements obtained by two GDH and two GOX BGMs at sea level and simulated altitude of 8000 feet in a hypobaric chamber were compared with measurements obtained using a YSI 2300 blood glucose analyzer as a reference method. Spiked venous blood samples of three different glucose levels were used. The accuracy of each meter was determined by calculating percentage error of each meter compared with the YSI reference and was also assessed against standard International Organization for Standardization (ISO) criteria. Clinical accuracy was evaluated using the consensus error grid method. The percentage (standard deviation) error for GDH meters at sea level and altitude was 13.36% (8.83%; for meter 1) and 12.97% (8.03%; for meter 2) with p = .784, and for GOX meters was 5.88% (7.35%; for meter 3) and 7.38% (6.20%; for meter 4) with p = .187. There was variation in the number of time individual meters met the standard ISO criteria ranging from 72-100%. Results from all four meters at both sea level and simulated altitude fell within zones A and B of the consensus error grid, using YSI as the reference.
CONCLUSIONS: Overall, at simulated altitude, no differences were observed between the performance of GDH and GOX meters. Overestimation of blood glucose concentration was seen among individual meters evaluated, but none of the results obtained would have resulted in dangerous failure to detect and treat blood glucose errors or in giving treatment that was actually contradictory to that required.
© 2012 Diabetes Technology Society.

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Year:  2012        PMID: 22920813      PMCID: PMC3440158          DOI: 10.1177/193229681200600418

Source DB:  PubMed          Journal:  J Diabetes Sci Technol        ISSN: 1932-2968


  11 in total

1.  A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose.

Authors:  J L Parkes; S L Slatin; S Pardo; B H Ginsberg
Journal:  Diabetes Care       Date:  2000-08       Impact factor: 19.112

2.  Performance of glucose dehydrogenase-and glucose oxidase-based blood glucose meters at high altitude and low temperature.

Authors:  Daniel Oberg; Claes-Göran Ostenson
Journal:  Diabetes Care       Date:  2005-05       Impact factor: 19.112

3.  Stabilization of glucose in blood specimens: mechanism of delay in fluoride inhibition of glycolysis.

Authors:  Leann M Mikesh; David E Bruns
Journal:  Clin Chem       Date:  2008-05       Impact factor: 8.327

4.  Influence of simulated altitude on the performance of five blood glucose meters.

Authors:  J F Gautier; A X Bigard; P Douce; A Duvallet; G Cathelineau
Journal:  Diabetes Care       Date:  1996-12       Impact factor: 19.112

5.  Performance of seven blood glucose testing systems at high altitude.

Authors:  B P Giordano; W Thrash; L Hollenbaugh; W P Dube; C Hodges; A Swain; C R Banion; G J Klingensmith
Journal:  Diabetes Educ       Date:  1989 Sep-Oct       Impact factor: 2.140

6.  Evaluating clinical accuracy of systems for self-monitoring of blood glucose.

Authors:  W L Clarke; D Cox; L A Gonder-Frederick; W Carter; S L Pohl
Journal:  Diabetes Care       Date:  1987 Sep-Oct       Impact factor: 19.112

7.  Errors in blood glucose determination.

Authors:  A de Pasqua; M B Mattock; R Phillips; H Keen
Journal:  Lancet       Date:  1984-11-17       Impact factor: 79.321

8.  Effect of high altitude on blood glucose meter performance.

Authors:  Kenneth S Fink; Dale B Christensen; Allan Ellsworth
Journal:  Diabetes Technol Ther       Date:  2002       Impact factor: 6.118

9.  The food and drug administration is now preparing to establish tighter performance requirements for blood glucose monitors.

Authors:  David C Klonoff
Journal:  J Diabetes Sci Technol       Date:  2010-05-01

10.  Accuracy of handheld blood glucose meters at high altitude.

Authors:  Pieter de Mol; Hans G Krabbe; Suzanna T de Vries; Marion J Fokkert; Bert D Dikkeschei; Rienk Rienks; Karin M Bilo; Henk J G Bilo
Journal:  PLoS One       Date:  2010-11-12       Impact factor: 3.240

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  4 in total

1.  Impact of partial pressure of oxygen in blood samples on the performance of systems for self-monitoring of blood glucose.

Authors:  Christina Schmid; Annette Baumstark; Stefan Pleus; Cornelia Haug; Martina Tesar; Guido Freckmann
Journal:  Diabetes Technol Ther       Date:  2013-11-08       Impact factor: 6.118

Review 2.  Glucose homeostasis during short-term and prolonged exposure to high altitudes.

Authors:  Orison O Woolcott; Marilyn Ader; Richard N Bergman
Journal:  Endocr Rev       Date:  2015-02-12       Impact factor: 19.871

3.  Glucose intolerance associated with hypoxia in people living at high altitudes in the Tibetan highland.

Authors:  Kiyohito Okumiya; Ryota Sakamoto; Yasuko Ishimoto; Yumi Kimura; Eriko Fukutomi; Motonao Ishikawa; Kuniaki Suwa; Hissei Imai; Wenling Chen; Emiko Kato; Masahiro Nakatsuka; Yoriko Kasahara; Michiko Fujisawa; Taizo Wada; Hongxin Wang; Qingxiang Dai; Huining Xu; Haisheng Qiao; Ri-Li Ge; Tsering Norboo; Norboo Tsering; Yasuyuki Kosaka; Mitsuhiro Nose; Takayoshi Yamaguchi; Toshihiro Tsukihara; Kazuo Ando; Tetsuya Inamura; Shinya Takeda; Masayuki Ishine; Kuniaki Otsuka; Kozo Matsubayashi
Journal:  BMJ Open       Date:  2016-02-23       Impact factor: 2.692

4.  Variability of capillary blood glucose monitoring measured on home glucose monitoring devices.

Authors:  Narendra Kotwal; Aditi Pandit
Journal:  Indian J Endocrinol Metab       Date:  2012-12
  4 in total

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