Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Perit Dial Int. 2010 May-Jun;30(3):329-35. doi: 10.3747/pdi.2008.00285. Epub 2010 Feb 26.
False elevation of blood glucose levels measured by glucose dehydrogenase pyrroloquinoline quinone (GDH-PQQ)-based glucose self-monitoring systems; glucometer) in peritoneal dialysis (PD) patients using icodextrin solution has been well documented. However, adverse hypoglycemic events caused by misreadings for blood glucose are still being reported. We aimed to study blood glucose levels measured simultaneously using different methods in PD patients with switching of icodextrin, and throughout daily exchanges either using icodextrin or not.
We recruited 100 PD patients, including 40 using icodextrin; 128 hemodialysis patients served as a reference. Fasting serum glucose was measured using our laboratory reference method (LAB) and 2 glucose self-monitoring systems based on glucose dehydrogenase nicotinamide adenine dinucleotide (GDH-NAD) and GDH-PQQ respectively. 80 PD patients had a second follow-up study. A time course study was performed in 16 PD patients through measuring fingertip glucose using the 2 glucose self-monitoring systems during daily exchanges.
The differences in measured serum glucose levels in (PQQ minus LAB) versus (NAD minus LAB) were markedly increased in PD patients using icodextrin compared to other patient groups, and was further confirmed by the follow-up study in patients that switched to icodextrin. The high serum glucose levels measured by the GDH-PQQ-based glucose self-monitoring system were present throughout all exchanges during the day in patients using icodextrin solution.
False elevation of blood glucose measured by GDH-PQQ-based glucose self-monitoring systems exists in patients using icodextrin. To avoid misinterpretation of hyperglycemia and subsequent over-injection of insulin, GDH-PQQ-based glucose self-monitoring systems should not be used in PD patients.
葡萄糖脱氢酶吡咯喹啉醌（GDH-PQQ）-基于葡萄糖自我监测系统（血糖仪）测量的血葡萄糖水平在使用艾考糊精溶液的腹膜透析（PD）患者中假性升高已有充分记载。然而，由于对血糖读数的误读导致的不良低血糖事件仍在报告。我们旨在研究切换艾考糊精后 PD 患者使用不同方法同时测量的血糖水平，以及全天是否使用艾考糊精进行日常交换。
我们招募了 100 名 PD 患者，其中 40 名使用艾考糊精；128 名血液透析患者作为参考。空腹血清葡萄糖使用我们的实验室参考方法（LAB）和基于葡萄糖脱氢酶烟酰胺腺嘌呤二核苷酸（GDH-NAD）和 GDH-PQQ 的 2 种葡萄糖自我监测系统分别进行测量。80 名 PD 患者进行了第二次随访研究。16 名 PD 患者进行了时间过程研究，通过在日常交换期间使用 2 种葡萄糖自我监测系统测量指尖血糖。
与其他患者组相比，使用艾考糊精的 PD 患者（PQQ 减去 LAB）与（NAD 减去 LAB）之间测量的血清葡萄糖水平差异明显增加，并且在切换到艾考糊精的患者的随访研究中得到了进一步证实。使用艾考糊精溶液的患者全天所有交换期间，基于 GDH-PQQ 的葡萄糖自我监测系统测量的高血糖水平均存在。
在使用艾考糊精的患者中，基于 GDH-PQQ 的葡萄糖自我监测系统测量的血糖假性升高。为避免对高血糖的误解和随后过度注射胰岛素，不应在 PD 患者中使用 GDH-PQQ 基于葡萄糖的自我监测系统。
