Department of Internal medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Health and Human Development (2HD) Research Network, Douala, Cameroon.
PLoS One. 2018 Aug 28;13(8):e0202271. doi: 10.1371/journal.pone.0202271. eCollection 2018.
Hydroquinone-containing creams cause false increases in capillary glycemia. However, the magnitude of this false increase, and the means to reverse it have not been investigated.
To evaluate the technical and clinical impact of hydroquinone-containing creams on capillary glycemia and investigate the efficacy of hand washing and other common practices, in reversing cream effects.
We included 91 participants in a quasi-experimental study in Buea, Cameroon. After determining the hydroquinone content of a cream, Caro Light, we used two glucometers with different enzymatic systems (Accu-Chek Active and OneTouch Ultra 2) to measure fasting glycemia after: initial hand washing (reference), application of 1 ml of hydroquinone-containing cream, finger swabbing with wet gauze, sanitizer application and a series of three hand washings following cream application. Reference glycemia was compared to those obtained after various interventions. Statistical significance was assessed by paired sample t-test, clinical significance by total error allowable (TEa), and clinical impact by Parke's error grid analysis.
The mean differences in capillary glycemia (Intervention-reference) measured by Accu-Chek Active in mg/dl were 28, 27, 38, 16, 4, and -2 after cream application, finger swabbing, sanitizer application, one, two, and three hand washings respectively. Corresponding values for OneTouch Ultra2 were 41, 44, 64, 22, 5 and -5. These differences, except after two and three hand washings were both statistically (p < 0.0001) and clinically significant (TEa). After cream application, Accu-Check had 9.9% of values in Parke's Zones C-E, while OneTouch had 18.7%.
Hydroquinone-containing creams cause significant false increase in capillary glycemia irrespective of the enzymatic system of the glucometer used, and can lead to potentially wrong clinical decisions. A minimum of two hand washings is required prior to capillary glucose measurement.
含有氢醌的乳膏会导致毛细血管血糖假性升高。然而，这种假性升高的程度以及逆转它的方法尚未得到研究。
评估含有氢醌的乳膏对毛细血管血糖的技术和临床影响，并研究洗手等常见操作在逆转乳膏效果方面的效果。
我们在喀麦隆布埃亚进行了一项准实验研究，纳入了 91 名参与者。在确定一种乳膏（Caro Light）中的氢醌含量后，我们使用两种具有不同酶系统的血糖仪（Accu-Chek Active 和 OneTouch Ultra 2）来测量空腹血糖：初始洗手（参考值）、应用 1 毫升含氢醌的乳膏、用湿纱布擦拭手指、使用消毒剂以及在涂抹乳膏后进行三次洗手。将参考血糖值与各种干预后的血糖值进行比较。采用配对样本 t 检验评估统计学显著性，采用总允许误差（TEa）评估临床显著性，采用 Parke 误差网格分析评估临床影响。
Accu-Chek Active 测量的毛细血管血糖（干预值-参考值）平均值在 mg/dl 单位下分别为：涂抹乳膏后 28、27、38、16、4 和-2，擦拭手指、使用消毒剂、一次洗手、两次洗手和三次洗手后的相应值分别为 41、44、64、22、5 和-5。OneTouch Ultra2 的相应值分别为 41、44、64、22、5 和-5。除了两次和三次洗手后，这些差异在统计学上（p<0.0001）和临床上（TEa）均具有显著性。涂抹乳膏后，Accu-Check 在 Parke 误差网格的 C-E 区有 9.9%的数值，而 OneTouch 有 18.7%。
含有氢醌的乳膏会导致毛细血管血糖假性升高，无论使用血糖仪的酶系统如何，都可能导致错误的临床决策。在进行毛细血管血糖测量之前，至少需要进行两次洗手。
