Correlation of the capillary and venous blood glucose levels using glucometer with fully automated chemistry analyzer for Stress Hyperglycemia among Critically Ill Patients
DOI:
https://doi.org/10.55629/pakjpathol.v35i2.797Abstract
Objective: To correlate venous and capillary blood glucose measurements using glucometer with fully automated chemistry analyser in stress hyperglycemia among critically ill patients.
Material and Methods: This cross-sectional study was conducted at Combined Military Hospital, Rawalpindi from August 2018 to January 2019 and blood specimens were analysed in Department of Chemical Pathology and Endocrinology Armed Forces Institute of Pathology Rawalpindi. Blood samples were collected from thirty-five non-diabetic patients of both genders admitted to Intensive Care Unit (ICU), Coronary Care Unit (CCU) and High Dependency Unit (HDU) of CMH, Rawalpindi. Venous and capillary blood glucose were measured using glucometer. Venous plasma glucose was analysed on fully automated chemistry analyser ADVIA 1800 by spectrophotometric kinetic method using Hexokinase.
Results: Mean (± Standard deviation) of Capillary Blood Glucose (CBG) was 160 (± 34.1) mg/dl, of Venous Blood Glucose (VBG) was 145.4 (± 33.9) mg/dl, and of fully automated chemistry analyser was 121 (± 35.4) mg/dl. Mean values of blood glucose showed significant difference (p<0.001) by three methods mentioned above. The CBG and VBG were found significantly correlated (r=0.91; p<0.001), similarly CBG and blood glucose levels (BGL) measured on automated chemistry analyser were also significantly correlated (r=0.79; p<0.001) as well as VBG and BGL measured on automated chemistry analyser (r=0.87; p<0.001)
Conclusion: A significant positive correlation was found between capillary and venous blood glucose measured by glucometers as well as between these two parameters and blood glucose measures on automated chemistry analyser but the means of these three values differ significantly. This warrants cautious use of glucometers for the detection of stress hyperglycaemia.
Keywords: Blood glucose monitoring, Critically ill patients, Glucometer, Stress hyperglycemia
References
Scheen M, Giraud R, Bendjelid K. Stress hyperglycemia, cardiac glucotoxicity, and critically ill patient outcomes current clinical and pathophysiological evidence. Physiol Rep. 2021; 9(2): e14713.
DOI: https://doi.org/10.14814/phy2.14713
American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes 2019. Diabet Care 2019; 42: S13–S28.
Li L, Zhao M, Zhang Z, Zhou L, Zhang Z, Xiong Y. et al. Prognostic significance of the stress hyperglycemia ratio in critically ill patients. Cardiovasc Diabetol. 2023; 22: 275.
DOI: https://doi.org/10.1186%2Fs12933-023-02005-0
Alhatemi G, Aldiwani H, Alhatemi R, Hussein M, Mahdai S, Seyoum B. Glycemic control in the critically ill: Less is more. Cleve Clin J Med. 2022; 89(4):191-9.
DOI: https://doi.org/10.3949/ccjm.89a.20171
Angelousi A, Margioris AN, Tsatsanis C. ACTH action on the adrenals. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K, editors. Endotext [Internet]. MDText.com, Inc.; South Dartmouth (MA): Jun 13, 2020.
Thau L, Gandhi J, Sharma S. Physiology, Cortisol. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov /books/NBK538239
Vedantam D, Poman D S, Motwani L, Asif N, Patel A, Anne KK, et al. Stress-induced hyperglycemia: Consequences and management. Cureus 2022. 14(7): e26714.
DOI: https://doi.org/10.3949/ccjm.89a.20171
Khalfallah M, Abdelmageed R, Elgendy E, Hafez YM. Incidence, predictors and outcomes of stress hyperglycemia in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention. Diab Vasc Dis Res. 2020; 17(1): 1479164119883983.
DOI: https://doi.org/10.1177/1479164119883983
Costea RM, Maniu I, Dobrota L, Neamtu B. Stress hyperglycemia as predictive factor of recurrence in children with febrile seizures. Brain Sci. 2020; 10(3): 131. DOI: https://doi.org/10.3390/brainsci10030131
Satti SA, Khattak AL, Tariq AM, Majoka SM, Naeem A, Din RU. The frequency of stress hyperglycemia and mortality in patients with hyperglycemia in medical intensive care unit. Pak Armed Forces Med J. 2021; 71(3): 753–56.
DOI: https://doi.org/10.51253/pafmj.v71i3.3298
Yang C, Chang C, Lin J. A comparison between venous and finger-prick blood sampling on values of blood glucose. Int Proceedings Chemical, Biologic Environment Engineering. 2012; 39: 206-10.
Sirohi R, Singh RP, Chauhan K. A comparative study of venous and capillary blood glucose in a tertiary care hospital. Indian J Pub Health Res Development. 2020; 11(7): 673-7.
Sharma K, Mogensen KM, Robinson MK. Pathophysiology of critical illness and role of nutrition. Nutr Clin Pract. 2019; 34(1): 12-22.
DOI: https://doi.org/10.1002/ncp.10232
Finfer S, Wernerman J, Preiser JC, Cass T, Desaive T, Hovorka R, et al. Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults. Crit Care. 2013; 17: 229.
DOI: https://doi.org/10.1186/cc12537
Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. Appendix 6C, page 79.
Yaraghi A, Mood NE, Dolatabadiali LK. Comparison of capillary and venous blood glucose levels using glucometer and laboratory blood glucose level in poisoned patients being in coma. Adv Biomed Res. 2015; 4: 247.
DOI: https://doi.org/10.4103/2277-9175.170242
Critchell CD, Savarese V, Callahan A, Aboud C, Jabbour S, Marik P. Accuracy of bedside capillary blood glucose measurements in critically ill patients. Intensive Care Med. 2007; 33(12): 2079-84.
DOI: https://doi.org/10.1007/s00134-007-0835-4
Boyd R, Leigh B, Stuart P. Capillary versus venous bedside blood glucose estimation. Emerg Med. 2005;22:177–9.
DOI: https://doi.org/10.1136/emj.2003.011619
Lacara T, Domagtoy C, Lickliter D, Quattrocchi K, Snipes L, Kuszaj J, et al. Comparison of point-of-care and laboratory glucose analysis in critically ill patients. Am J Crit Care. 2007; 16(4): 336-46.
Jyoti S, Renu B Singh, Seema. Correlation of venous blood sugar measured by lab method and capillary blood sugar measured by glucometer in neurosurgical patients receiving dexamethasone. Asian J Neurosurg. 2023; 19 (1); 21-25.
DOI: https://doi.org/10.1055/s-0043-1775569
Funk DL, Chan L, Lutz N, Verdile VP. Comparison of capillary and venous glucose measurements in healthy volunteers. Prehosp Emerg Care. 2001; 5: 275–7.
DOI: https://doi.org/10.1080/10903120190939788
Petersen JR, Graves DF, Tacker DH, Okorodudu AO, Mohammad AA, Cardenas VJ Jr. Comparison of POCT and central laboratory blood glucose results using arterial, capillary, and venous samples from MICU patients on a tight glycemic protocol. Clin Chim Acta. 2008; 396:10-3.
DOI: https://doi.org/10.1016/j.cca.2008.06.010
Du Bose JJ, Inaba K, Branco BC, Barmparas G, Lam L, Teixeira PG, et al. Discrepancies between capillary glucose measurements and traditional laboratory assessments in both shock and nonshock states after trauma. J Surg Res. 2012; 178: 820–6. DOI: https://doi.org/10.1016/j.jss.2012.04.003
FekihHassen M, Ayed S, Gharbi R, Ben Sik Ali H, S. Marghli S, Elatrous S. Bedside capillary blood glucose measurements in critically ill patients: Influence of catecholamine therapy. Diabetes Res Clin Pract. 2010; 87: 87–91.
DOI: https://doi.org/10.1016/j.diabres.2009.09.018
Adnan M, Imamb F, Shabbira I, Alia Z, Rahata T. Correlation between capillary and venous blood glucose levels in diabetic patients. Asian Biomed. 2015 Mar 23;9(1):55-9.
DOI: https://doi.org/10.5372/1905-7415.0901.368
Patel N, Patel K. A comparative study of venous and capillary blood glucose levels by different methods. GCSMC J Med Sci. 2015;4(1):53-6.
Bar-Or D, Rael L T, Madayag RM, Banton K.L, Tanner A, Acuna DL et al. Stress Hyperglycemia in Critically Ill Patients: Insight Into Possible Molecular Pathways. Front Med 2019; 6: 54.
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