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ANALYTICAL INTERFERENCES IN POINT-OF-CARE TESTING GLUCOMETERS BY ICODEXTRIN AND ITS METABOLITES: AN OVERVIEW

Department of Clinical Chemistry, University Hospital Ghent, Belgium

Correspondence to: J.R. Delanghe, Laboratory of Clinical Chemistry, Ghent University Hospital (2P8), De Pintelaan 185, B-9000 Ghent, Belgium. Joris.Delanghe{at}ugent.be

Current point-of-care testing (POCT) glucometers are based on various test principles. Two major method groups dominate the market: glucose oxidase-based systems and glucose dehydrogenase-based systems using pyrroloquinoline quinone (GDH-PQQ) as a cofactor. The GDH-PQQ-based glucometers are replacing the older glucose oxidase-based systems because of their lower sensitivity for oxygen. On the other hand, the GDH-PQQ test method results in falsely elevated blood glucose levels in peritoneal dialysis patients receiving solutions containing icodextrin (e.g., Extraneal; Baxter, Brussels, Belgium). Icodextrin is metabolized in the systemic circulation into different glucose polymers, but mainly maltose, which interferes with the GDH-PQQ-based method. Clinicians should be aware of this analytical interference. The POCT glucometers based on the GDH-PQQ method should preferably not be used in this high-risk population and POCT glucose results inconsistent with clinical suspicion of hypoglycemic coma should be retested with another testing system.

KEY WORDS: Icodextrin; hyperglycemia; point-of-care testing; maltose; GDH-PQQ.

Received 5 June 2008; accepted 27 January 2009.

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