title: Blood glucose measurement in patients with suspected diabetic ketoacidosis: a comparison of Abbott MediSense PCx point-of-care meter values to reference laboratory values.
abstract: BACKGROUND
  The purpose of this study is to compare blood glucose levels measured by a point of care (POC) device to laboratory measurement using the same sample venous blood from patients with suspected diabetic ketoacidosis (DKA).
  
  
  METHODS
  A descriptive correlational design was used for this IRB-approved quality assurance project. The study site was the 50-bed BMC emergency department (ED) which has an annual census of over 100,000 patient visits. The convenience sample consisted of 54 blood samples from suspected DKA patients with orders for hourly blood draws for glucose measurement. Spearman correlations of the glucose POC values, reference lab values, and differences between the two, were evaluated. A chi-square test was used to evaluate the association between the acidosis status and FDA acceptability of POC values.
  
  
  RESULTS
  Patient age range was 10-86 years; 63% were females; 46% had a final diagnosis of DKA. POC values underestimated glucose levels 93% of the time. There was a high correlation between the lab value and the magnitude of the difference, (lab minus POC value) indicating that the higher the true glucose value, the greater the difference between the lab and the POC value. A chi-square test showed no overall association between acidosis and FDA-acceptability.
  
  
  CONCLUSIONS
  The POC values underestimated lab reported glucose levels in 50 of 54 cases even with the use of same venous sample sent to the lab, which make it highly unreliable for use in monitoring suspected DKA patients.
authors.affiliation: Emergency Medicine, Baystate Medical Center, Springfield, and Emergency Medicine, Tufts University, School of Medicine, Boston, MA, USA. del.blank@bhs.org
authors.forename: Fidela S J
authors.initials: FS
authors.lastname: Blank
authors.forename: Moses
authors.initials: M
authors.lastname: Miller
authors.forename: James
authors.initials: J
authors.lastname: Nichols
authors.forename: Howard
authors.initials: H
authors.lastname: Smithline
authors.forename: Gillian
authors.initials: G
authors.lastname: Crabb
authors.forename: Penelope
authors.initials: P
authors.lastname: Pekow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D001800:Blood Specimen Collection; D002648:Child; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000175:diagnosis; D016529:Emergency Nursing / Q000379:methods; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007755:Laboratories, Hospital; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001786:Blood Glucose