Real-world data from Europe and Africa suggest that accuracy of systems for self-monitoring of blood glucose is frequently impaired by low hematocrit
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AIMS: Certain systems for self-monitoring of blood glucose (SMBG) demonstrate inaccuracy at low and high hematocrit (HCT). Manufacturers define HCT ranges for accurate performance. Our objective was to assess the frequency of HCT values that can lead to clinically relevant errors. METHODS: In this cross-sectional study, we collected real-world data representing over 360,000 outpatients from the Netherlands (NL), the Czech Republic (CZ), and South Africa (ZA). These were subsequently stratified by sex and age and compared to commonly specified HCT range limits, reference intervals, and data from 1780 healthy Czech subjects. RESULTS: HCT values were comparably distributed in NL and CZ. Outpatients had a higher dispersion of values than healthy subjects. Low HCT values in Europe were common in age groups with a high prevalence of diabetes. All ZA age groups showed a higher prevalence of low HCT than in Europe. CONCLUSIONS: Real-world data indicate that SMBG systems specified to perform only within the frequently used 30-55% HCT range would leave 3% of outpatients in Europe and 18% in South Africa at risk of false SMBG results, with individual age strata being substantially higher. This could affect their diabetes management. Adequate SMBG systems should thus be chosen.
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Low hematocrit due to iron deficiency or chronic diseases, as well as high hematocrit, can markedly affect the measurement accuracy of SMBG systems.
“Low HCT due, for example, to iron deficiency or chronic diseases, as well as high HCT can markedly affect the measurement accuracy of SMBG systems [29, 30].”
From Self-Monitoring of Blood Glucose as an Integral Part in the Management of People with Type 2 Diabetes Mellitus (2022) · cites this paper as [30]
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von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.11.008 · Cited by 17,893 · see citing works
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, F. T. S. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-8-200710160-00010 · Cited by 17,796 · see citing works
Buist, A. S., McBurnie, M. A., Vollmer, W. M., Gillespie, S., Burney, P., Mannino, D. M., Menezes, A. M., Sullivan, S. D., Lee, T. A., Weiss, K. B., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61377-4 · Cited by 2,364 · see citing works
A systematic analysis of global anemia burden from 1990 to 2010
Kassebaum, N. J., Jasrasaria, R., Naghavi, M., Wulf, S. K., Johns, N. E., Lozano, R., Regan, M. C., Weatherall, D. J., Chou, D. P., Eisele, T. P., et al. (2013) · Blood · doi:10.1182/blood-2013-06-508325 · Cited by 2,115 · see citing works
Kassebaum, N. J. (2016) · Hematology/Oncology Clinics of North America · doi:10.1016/j.hoc.2015.11.002 · Cited by 789 · see citing works
Factors affecting blood glucose monitoring: sources of errors in measurement
Ginsberg, B. H. (2009) · Journal of Diabetes Science and Technology · doi:10.1177/193229680900300438 · Cited by 348 · see citing works
Tang, Z., Lee, J. H., Louie, R. F., & Kost, G. J. (2000) · Archives of Pathology & Laboratory Medicine · doi:10.5858/2000-124-1135-eodhlo · Cited by 293 · see citing works
Anemia, Diabetes, and Chronic Kidney Disease
Mehdi, U. F., & Toto, R. D. (2009) · Diabetes Care · doi:10.2337/dc08-0779 · Cited by 244 · see citing works
Adam, S., & Rheeder, P. (2017) · South African Medical Journal · doi:10.7196/samj.2017.v107i6.12043 · Cited by 119 · see citing works
Breton, M. D., & Kovatchev, B. P. (2010) · Journal of Diabetes Science and Technology · doi:10.1177/193229681000400309 · Cited by 103 · see citing works
The prevalence of type 2 diabetes in South Africa: a systematic review protocol
Pheiffer, C., Wyk, V. P., Joubert, J., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-021029 · Cited by 63 · see citing works
Abay, F., Yalew, A., Shibabaw, A., et al. (2018) · Tuberculosis Research and Treatment · doi:10.1155/2018/5740951 · Cited by 47 · see citing works
Kilpatrick, E. S., Rumley, A. G., Myint, H., Dominiczak, M. H., & SMALL, M. P. (1993) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456329303000513 · Cited by 44 · see citing works
Kahase, D., Solomon, A., & Alemayehu, M. (2020) · Journal of Blood Medicine · doi:10.2147/jbm.s237317 · Cited by 29 · see citing works
Lyon, M. E., & Lyon, A. W. (2011) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2011.01.005 · Cited by 27 · see citing works
Study the relationship of erythropoietin and chronic obstructive pulmonary disease
Elkorashy, R. I., Amin, Y., Moussa, H. A., Badawy, I., & Bakr, S. (2012) · Egyptian Journal of Chest Diseases and Tuberculosis · doi:10.1016/j.ejcdt.2012.10.026 · Cited by 20 · see citing works
Pfützner, A., Schipper, C., Ramljak, S., Flacke, F., Sieber, J., Forst, T. M., & Musholt, P. B. (2013) · Journal of Diabetes Science and Technology · doi:10.1177/193229681300700122 · Cited by 16 · see citing works
Hattemer, A., & Wardat, S. (2018) · Journal of Diabetes Science and Technology · doi:10.1177/1932296818757550 · Cited by 8 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Baltaro RJ, Dangott BJ, Tanenberg RJ, Thombare A, Lin SF. Evaluation of Hematocrit and Hypoglycemia in a University Hospital: Blood Glucose Monitoring Experience Using Retrospective Data Analysis. Am. Diabetes Assoc. ADA 75th Sci. Sess., Boston, Massachusetts; 2015. https://doi.org/ 10.1177/193229681300700122. · DOI
- Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, et al. South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press; 2013.
- Hinzmann R. Accuracy of blood glucose monitoring is essential for correct therapy decisions 2019. Congress of the International Diabetes Federation (IDF) 2019, Roche Satellite Symposium; 2019. Busan, South Korea.
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Pleus, S., Freckmann, G., Schauer, S., Heinemann, L., Ziegler, R., Ji, L., Mohan, V., Calliari, L. E., & Hinzmann, R. (2022) · Diabetes Therapy · doi:10.1007/s13300-022-01254-8 · Cited by 55 · see citing works
Self-citation
- Authors
- Hinzmann, R., Militz, D., Zima, T., Špaček, M., Storm, H., Chapanduka, Z., & Hauss, O.
- Affiliations
- Roche Diabetes Care GmbH (Germany) (DE)
- Charles University (CZ)
- Stichting Certe Medische Diagnostiek en Advies (NL)
- Stellenbosch University (ZA)
- Corresponding author
- Hinzmann, Rolf
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 177
- Pages
- 108860
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W3162529700
- Cited by
- 2
- References
- 18
- Citations by year
- 2024: 1 · 2022: 1
- FWCI
- 0.37
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Research and Clinical Practice (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Roche Diabetes Care
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- self-monitoring of blood glucose, hematocrit, blood glucose meter accuracy, low hematocrit, measurement error, diabetes management, outpatients, age-stratified prevalence, reference values, South Africa, Europe
- MeSH terms
- Blood Glucose, Cross-Sectional Studies, Europe, Hematocrit, Humans, South Africa, Blood Glucose Self-Monitoring
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