You respond to the home of a 56 YOM for a 3rd party caller reporting their family member is confused. Upon arrival, you note that the patient has diabetic medications in the house as well as an IV pump with a medication you are not familiar with. Blood sugar on your glucometer is 148 mg/dl. You transport him to the hospital, where lab glucose determines that he is actually hypoglycemic.
The patient was taking a medication called Extraneal, which contains Icodextrin and is used for peritoneal dialysis. This can affect certain types of glucometers, leading to false high readings. Do you know which type of glucometer you have? Find out here.
Here are common types:
- Glucose Dehydrogenase Pyrroloquinoline Quinone (GDH-PQQ)
- Glucose Dehydrogenase Flavin-Adenine Dinucleotide (GDH-FAD)
- Glucose Dehydrogenase Nicotinamide-Adenine Dinucleotide (GDH-NAD)
- FDA Public Health Notification: Potentially Fatal Errors with GDH-PQQ* Glucose Monitoring Technology. (2009, August 13). Retrieved January 10, 2017
- de Lange, S., Fernández Cabrera, J., & Gomar Vidal, S. (2011). [Occult hypoglycemia in patient with chronic kidney failure and chronic ambulatory peritoneal dialysis]. Medicina intensiva, 2, 133–134.
- Floré, K. M., & Delanghe, J. R. (). Analytical interferences in point-of-care testing glucometers by icodextrin and its metabolites: an overview. Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 4, 377–383.
- Khouli, M. M. (2012). Masked hypoglycemia in the presence of icodextrin for peritoneal dialysis. The Journal of emergency medicine, 2, e191-3.
- Al-Dorzi, H. M., Al-Sum, H., Alqurashi, S., et al. (2011). Severe hypoglycemia in peritoneal dialysis patients due to overestimation of blood glucose by the point-of-care glucometer. Saudi journal of kidney diseases and transplantation, Saudi Arabia, 4, 764–768.
- Grassmann, A., Gioberge, S., Moeller, S., & Brown, G. (2005). ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrology, dialysis, transplantation, 12, 2587–2593.