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POCT Glucose, Fingerstick
|Performed by||Authorized Point of Care testing site staff|
|In House Availability||Test available 24 hours per day 7 days per week|
|Method||Roche Accucheck Inform glucometer|
|Amount to Collect||One drop|
|Sample type||Capillary blood (fingerstick)|
See Additional information for information on interferences with POCT glucose determinations
|Synonyms||Point of care; POCT; glucometer|
|Additional information|| This test is subject to several interferences that can significantly impact the glucose result. Please see below.
Hematocrit: A Hct of < 20% may yield spuriously high glucose results . Conversely if the hematocrit is > 55%, the glucose test results may be spuriously low. Blood samples for patient's with hematocrit levels < 20% or > 55% should be sent to the lab for glucose testing.
Other Sugars: Patients on parenteral treatments containing Maltose (see information on Hepagam below) or Galactose or patients receiving oral Xylose should not be tested using the Accu-Chek Inform meter. The test is sensitive to these sugars and may result in a falsely elevated glucose reading. Blood samples for these patients should be sent to the lab for glucose testing during the administration of such products and for 24 hours after they are discontinued. Note that these sugars may be used as stabilizing agents for some pharmaceuticals (e.g. IVIG) and therefore it may not be readily apparent that a patient is at risk for this interference. Contact Pharmacy for any questions about drugs that may contain these sugars.
Note: An evaluation of patients at UCSF receiving Hepagam (contains maltose) demonstrated that the magnitude of the interference was not as significant as anticipated. It is acceptable to perform POCT blood glucose in these patients. However, a confirmatory test should be sent to the clinical laboratory for fingerstick glucose values that are > 250 mg/dL prior to adjusting insulin.
Bilirubin: Unconjugated bilirubin levels > 20 mg/dL may produce elevated POCT glucose values. An evaluation of this at UCSF demonstrated the effect to be variable and relatively small. It is acceptable to perform POCT blood glucose in these patients. However, a confirmatory test should be sent to the clinical laboratory for fingerstick glucose values that are > 250 mg/dL prior to adjusting insulin.
Lipemia: Lipemia at levels > 5000 mg/dL while uncommon may result in elevated glucose results with this method. Samples in these patients should be sent to the clinical laboratory for analysis.
Acetaminophen: Acetaminophen administration in normal doses does not cause an interference, However, at levels > 8 mg/dL (80 mg/L; normal therapeutic range for Acetaminophen = 10-20 mg/L) acetaminophen may result in elevated glucose levels by this method. In overdose situations samples should be sent to the clinical laboratory for testing.
Uric acid: Increased uric acid may result in elevated glucose results with this method. The level of uric acid that may result in an interference is dependent on the actual glucose level:
Decreased blood flow: In situations of decreased blood flow, fingerstick blood testing may not be appropriate, since it may not reflect the true physiological state. Examples would include, but are not limited to severe dehydration caused by diabetic ketoacidosis or the hyperglycemic hyperosmolar nonketotic state, hypotension, shock, or peripheral vascular disease.
|LDT or Mod FDA?||No|
|Last Updated||5/22/2013 1:56:16 PM|