Evaluation of accuracy of FAD-GDH- and mutant Q-GDH-based blood glucose monitors in multi-patient populations

Clin Chim Acta. 2014 Jun 10:433:28-33. doi: 10.1016/j.cca.2014.02.023. Epub 2014 Mar 5.

Abstract

Background: Glucose dehydrogenases have been highly promoted to high-accuracy blood glucose (BG) monitors. The flavin adenine dinucleotide glucose dehydrogenase (FAD-GDH) and mutant variant of quinoprotein glucose dehydrogenase (Mut. Q-GDH) are widely used in high-performance BG monitors for multi-patient use. Therefore we conducted accuracy evaluation of the GDH monitors, FAD-GDH-based GM700 and Mut. Q-GDH-based Performa.

Methods: Different patients were enrolled: patients with and without diabetes, patients receiving respiratory therapies, hemodialysis (HD) and peritoneal dialysis (PD) patients, and neonates. The accuracy evaluation of FAD-GDH- and Mut. Q-GDH-based monitors referred to ISO 15197:2013 which applies new criteria for the minion accuracy requirements: more than 95% of the blood glucose readings shall fall within ±15mg/dL of the reference method at glucose concentration <100mg/dL and within ±15% of the reference method at glucose concentration ≥100mg/dL. Bland-Altman plots were used to evaluate the 2 GDH monitors as well.

Results: Bland-Altman plots visualized excellent precision of the BG monitors. The 95% limit agreement of overall results for the FAD-GDH-based monitors was within ±12% and that for the Mut. Q-GDH-based monitors was from -10 to +17%. Both BG monitors met the accuracy requirements of ISO 15197:2013. The FAD-GDH-based monitor performed better with neonates and patients with and without diabetes, and the Mut. Q-GDH-based monitor performed better with HD and PD patients.

Conclusions: Analytical results prove that the GDH-based monitors tolerate a broad BG concentration range, are oxygen independent, have BG specificity, and have minimal interference from hematocrit. The GDH-based monitors are reliable for multi-patient use.

Keywords: Arterial blood; Blood glucose monitoring system; Glucose dehydrogenase; Hemodialysis; ISO 15197:2013; Neonate.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Chemical Analysis / methods*
  • Blood Chemical Analysis / standards
  • Blood Glucose / analysis*
  • Female
  • Flavin-Adenine Dinucleotide / metabolism*
  • Glucose Dehydrogenases / genetics*
  • Glucose Dehydrogenases / metabolism*
  • Humans
  • Infant, Newborn
  • Male
  • Middle Aged
  • Mutation*
  • Young Adult

Substances

  • Blood Glucose
  • Flavin-Adenine Dinucleotide
  • Glucose Dehydrogenases
  • glucose dehydrogenase (pyrroloquinoline-quinone)