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  • Title: Glucose meters: What's the laboratory reference glucose?
    Author: Carta M, Giavarina D, Paternoster A, Bonetti G.
    Journal: J Med Biochem; 2020 Jan 10; 39(1):32-39. PubMed ID: 32549775.
    Abstract:
    BACKGROUND: The accuracy of glucose meters is evaluated by comparing their results with those from a reference laboratory glucose analyser. The main scientific societies recommend the use of a prompt glycolysis inhibitor such as citrate for an accurate glucose determination. In the present preliminary study, we discuss the bias between capillary and plasma glucose measured concentrations, determined in two Italian clinical laboratories, using tubes containing an NaF and citrate mixture in liquid and granular form. METHODS: 139 volunteers in whom 75 g OGTT was requested were recruited. Basal capillary glucose was determined using Abbott FreeStyle Precision Neo in Brescia (n=63), while clinical laboratory reference P-glucose was determined using tubes containing NaF/K3EDTA and liquid NaF/Na2EDTA/citrate. Basal capillary glucose was determined using a Roche Cobas Accu-Chek Inform II in Vicenza (n=76), while P-glucose was determined using tubes containing NaF/K2Ox and NaF/Na2EDTA/citrate in granulated form. Reference P-glucose was determined with a hexokinase method on Dimension Vista systems. Differences between capillary and reference P-glucose were evaluated according to ADA/ISO 15197:2013 specifications. RESULTS: 96.82% and 97.37% of capillary determinations were within specifications when liquid and granular citrate mixture tubes were used, respectively. Conversely, only 73.02% and 80.26% of determinations were within criteria using NaF. CONCLUSIONS: It's important to know what is the laboratory reference glucose in evaluating glucose meters' accuracy. The evaluation of glucometers' accuracy with respect to a reference laboratory may be wrong if tubes containing only NaF are used due to in vitro glycolysis. Only tubes containing citrate mixture permit the correct evaluation of glucose meters' accuracy. UVOD: Tačnost glukometra se procenjuje poređenjem njihovih rezultata sa rezultatima dobijenim referentnim analizatorom za glukozu. Stručna zajednica preporučuje upotrebu brzog inhibitora glikolize kao što je citrat za precizno određivanje glukoze. U ovoj preliminarnoj studiji razmatrana su odstupanja između izmerenih koncentracija kapilarne glukoze i glukoze u plazmi, koje su obavljene u dve italijanske referentne laboratorije, primenom epruveta sa mešavinom NaF i citrata u tečnom i granularnom obliku. METODE: Odabrano je 139 dobrovoljaca i od njih zatraženo da urade OGTT test sa 75 g glukoze. Bazalna kapilarna glukoza je određena korišcenjem Abbott FreeStyle Precision Neo u Breši (n=63), dok je labor ato rijska referentna P-glukoza određivana korišćenjem NaF/K3EDTA i tečnih NaF/Na2EDTA/citrata koji sadrže epruvete. Bazalna kapilarna glukoza je određena korišće njem Roche Cobas Accu-Chek Inform II u Vićenci (n=76), dok je P-glukoza određena pomoću NaF/K2Ok i NaF/Na2EDTA/citrata u granularnoj formi koja sadrži epruvete. Referentna P-glukoza je određena metodom heksokinaze na Dimension Vista sistemima. Razlike između kapilarne i referentne P-glukoze su procenjene prema ADA/ISO 15197:2013 specifikacijama. REZULTATI: 96,82% i 97,37% kapilarnih određivanja bilo je u okviru specifikacija kada su korišćene epruvete sa tečnom i granularnom mešavinom citrata. Nasuprot tome, samo 73,02% i 80,26% određivanja je bilo u okviru kriterijuma pomoću NaF. ZAKLJUČAK: Važno je znati šta je laboratorijska referentna glukoza u proceni tačnosti glukometra. Ispitivanje preciznosti glukometra u odnosu na referentu laboratoriju može biti pogrešno ako se koriste epruvete koje sadrže samo NaF zbog in vitro glikolize. Samo epruvete koje sadrže citratnu mešavinu omogućavaju ispravnu procenu tačnosti glukometra.
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