title: Unrecognized hypoglycemia due to maltodextrin interference with bedside glucometry.
abstract: BACKGROUND
  Glucometry is widely used to confirm or exclude hypoglycemia in patients with suggestive clinical findings. Nonglucose sugars may be detected by certain types of glucometers, causing false elevation of the glucometer analysis of the blood sugar. Since these other sugars are not functionally glucose and may even induce excess insulin release, clinical hypoglycemia may be missed.
  
  
  METHODS
  We report a 79-year-old man on enteral feeds containing maltodextrin, a glucose polymer, who had persistently high glucometer-measured blood glucose despite normal blood glucose measured by formal laboratory analysis.
  
  
  CONCLUSIONS
  Excess insulin administration, based on the erroneous glucometer reading, may have caused unrecognized fatal clinical hypoglycemia. This has been reported following intravenous administration of related nonglucose sugars but not with enteral maltodextrin. Further study is required to confirm the effects of maltodextrin on glucometry.
  
  
  CONCLUSIONS
  False elevation of blood glucose measured on certain point-of-care glucometers can occur following the oral administration of maltodextrin.
authors.affiliation: Department of Surgery, Section of Emergency Medicine. Yale University School of Medicine, New Haven, CT 06511, USA. bmkirrane@gmail.com
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Kirrane
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Duthie
authors.forename: Lewis S
authors.initials: LS
authors.lastname: Nelson
mesh_terms: D000368:Aged; D016477:Artifacts; D001786:Blood Glucose / Q000378:metabolism*; D003951:Diagnostic Errors; D004750:Enteral Nutrition; D017809:Fatal Outcome; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007328:Insulin / Q000009:adverse effects; D008297:Male; D008508:Medication Errors; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D019095:Point-of-Care Systems; D011134:Polysaccharides / Q000008:administration & dosage* / Q000097:blood; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D011134:Polysaccharides; C008315:maltodextrin