[Hypoglycaemic coma due to falsely elevated glucose values in a patient with diabetes mellitus and peritoneal dialysis].
A 45-year-old female diabetes-mellitus patient on peritoneal dialysis was admitted because of vertigo. During her stay in hospital she developed a comatose condition with abnormal head posture and deviation ofthe eyes to the left. Capillary blood from the fingertip showed a glucose value of 15.4 mmol/l. However, the automatically obtained glucose value delivered with a blood-gas analysis was found to be 1.2 mmol/l. The neurological state of the patient normalised fully after intravenous glucose administration. The glucose values were falsely elevated because the patient used a peritoneal dialysis fluid at night which contained icodextrin as an osmotic agent. Metabolites of icodextrin can influence blood-glucose measurements taken using analyzers that depend on the enzyme glucose dehydrogenase. To prevent potentially life-threatening situations, the use of an adequate glucose meter is of paramount importance.
Nienhuis
W A
WA
Scheper Ziekenhuis, Boermarkeweg 60, 7824 AA Emmen.
Bruijns
R H J
RH
Vastenburg
G
G
Wouters
R S M E
RS
D001322:Autoanalysis / Q000295:instrumentation*; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003926:Diabetic Coma / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005936:Glucans / Q000009:adverse effects*; D005947:Glucose / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000077607:Icodextrin; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D016896:Treatment Outcome
D001786:Blood Glucose; D005936:Glucans; D000077607:Icodextrin; D005947:Glucose