Comparison of Blood Glucose Values Using Two Glucose Meters and Standard Laboratory Method in Hospitalized Patients in a Teaching Hospital
Background: Diabetes mellitus is a chronic disease with a worldwide prevalence and its complications can be prevented with close monitoring of blood glucose. Quality of blood glucose monitoring utilizing glucometers in Iranian hospitalized patients has not been well published in the literature. We evaluated the accuracy and consistency of the results of two devices compared with the standard laboratory method used for measuring glucose levels in a teaching hospital.
Methods: In this study 100 patients with the average age of 57.5 ±17.7 years were randomly selected from 19 wards and their blood glucose were simultaneously measured using Accu-Chek Active®(1) and Cleverchek®(2) (commonly used in the wards) and the conventional laboratory method. Calibration was performed on both devices.
Results: Absolute Mean Difference of the devices 1 and 2 from the laboratory values were 24.3±2.4,and 38.5±4.5, respectively (P: 0.003). Correlation coefficient of the obtained values by glucometers1 and 2 with lab, were 0.82 and 0.52, respectively. Calibration of the devices showed that device 1 was the most consistent device with the laboratory values, and Pearson correlation coefficient between the obtained values as a result of four reiterations for each sample in each device showed that the highest coefficient belonged to the device 1 and the least belonged to the device 2 used in the Ear, Nose, and Throat Departments.
Conclusion: The device 2 used in different wards of the hospital must be calibrated periodically. Furthermore, the device 1 generated closest results to the ones obtained through the laboratory.
Afkhami M, Vahidi S, Vahidi A, Ahmadian MH. Epidemiological Survey of NIDDM in Persons Over 30-Year Old in Yazd Province. J Shahid Sadoughi University Med Sciences 2001; 9:22-7.
King H, Aubert RE, Herman WH. Global burden of diabetes 1995 – 2025. Diabet Care 1998; 21(9):1414-31.
Kelin R. Recent development in the understanding and management of diabetetic retinopathy. Med Clin North Am 1988; 72: 1415-37.
WHO study Group. Prevention of Diabetes Mellitus, WHO technical series 844.Geneva: World Health Organization; 1994.
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.
Rodbard HW, Blonde L, Braithwaite SS, et al. AACE Diabetes Mellitus Clinical Practice Guidelines Task Force. American Association of Clinical endocrinologist medical guidelines for clinical practice for the management of diabetes mellitus. Endocrine Pract 2007; 13 (Suppl. 1):1–68.
IDF Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes: recommendations for standard, comprehensive, and minimal care. Diabet Med 2006; 23(6):579–93.
Lefevre G, Girardot-Dubois S, Chevallier G, et al. Evaluation of the Quality of Blood Glucose Meters Usingthe HemoCue B Glucose System. Diabetes Metab 1999; 25(4):350-55.
Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Peterson CM. Tests of Glycemia in Diabetes. Diabet Care 1995; 18: 896-909.
Chan JC, Wong RY, Cheung CK, et al. Accuracy, Precision and User Acceptability of Self Blood Glucose Monitoring Machines. Diabetes Res Clin Pract 1997; 36(2): 91-104.
Larijani B, Bastanhagh MH, Shirvan AR, et al. Evaluation of the Efficacy of Blood Glucose Home Monitoring Devices. Med Sci Monit 2007; 13(3):PI1-6
Rao A, Wiley M, Iyengar S, Nadeau D, Carnevale J. Individuals achieve more accurate results with meters that are codeless and employ dynamic electrochemistry. J Diabetes Sci Technol 2010; 4(1):145–50.
Rice MJ. Dynamic electrochemistry: a step in the right direction. J Diabetes Sci Technol 2011; 5(5):1176–8.
Musholt PB, Schipper C, Thomé N, et al. Dynamic electrochemistry corrects for hematocrit interference on blood glucose determinations with patient self measurement devices. J Diabetes Sci Technol 2011;5(5):1167–75.
Kempf K, Heinemann L. Dynamic electrochemistry: an innovative method for high-quality blood glucose monitoring. Diabetologie und Stoffwechsel 2012;7(2):121–6.
Freckmann G, Schmid C, Baumstark A, Pleus S, Link M, Haug C. System accuracy evaluation of 43 blood glucose monitoring systems for selfmonitoring of blood glucose according to DIN EN ISO 15197. J Diabetes Sci Technol 2012;6(5):1060-75.
Boyd R, Leigh B, Stuart P. Capillary versus venous bedside blood glucose estimations. Emerg Med J 2005; 22(3):177-9.
Mitsios JV, Ashby LA, Haverstick DM, Bruns DE, Scott MG. Analytic evaluation of a new glucose meter system in 15 different critical care settings. J Diabetes Sci Technol 2013; 7(5):1282-7.
Sachse D, Bolstad N, Jonsson M, et al. The Accu-Chek Mobile blood glucose monitoring system used under controlled conditions meets ISO 15197 standards in the hands of diabetes patients. Scand J Clin Lab Invest 2012; 72(5):374-9.
Dhatt GS, Agarwal MM, Othman Y, Nair SC. Performance of the Roche Accu-Chek active glucose meter to screen for gestational diabetes mellitus using fasting capillary blood. Diabetes Technol Ther 2011; 13(12):1229-33.
American Diabetes Association. Standards of medical care in diabetes-2008. Diabet Care 2008; 31(Suppl. 1):S12-S54.
Franek J. Self-management support interventions for persons with chronic disease: an evidence-based analysis. Ont Health Technol Assess Ser 2013;13(9):1-60.
Lankarani M, Zahedi F. Primary prevention of type 2 diabetes mellitus. Iranian Journal of Diabetes and Lipid Disorders 2002; 1:87-106.
Usmani HA, Khan II, Mughal FH. A study of the accuracy of the Precision Q.I.D. glucometer. J Pak Med Assoc 1998; 48:114-6.
Essack Y, Hoffman M, Rensburg M, Van Wyk J, Meyer CS, Erasmus R. A comparison of five glucometers in South Africa. JEMDSA 2009; 14(2):102-105
Ginsberg BH. Factors affecting blood glucose monitoring: sources of errors in measurement. J Diabetes Sci Technol 2009;3(4):903-13.