Pourbiax Diagrams as an Aid to Understanding the Impact of Acid/Base Disturbance on Blood Glucose Point-of-Care Testing

Abstract

Objective: Assays based on redox reactions that involve proton transfer are vulnerable to artifactual findings in metabolic acidosis/alkalosis. We evaluated the impact of pH on the measurement of blood glucose by the glucose dehydrogenase/pyrroloquinoline quinone system used in point-of-care-testing.

Methods: We applied a series of thermodynamic equations to adjust the Gibbs energy for the pyrroloquinoline quinone couple. This adjusts values taken under standard conditions to those more closely resembling the physiological state.

Results: Under standard conditions, the pyrroloquinoline quinone couple has Eo = -0.125 V whereas adjustment to the physiological state (pH 7.40, ionic strength 0.15 mol/L, and temperature 310.15°K) yields Eo' = -0.166 V. This corresponds to an uncertainty in blood glucose determination of approximately 0.13 mmol/L.

Conclusion: We have demonstrated that the impact of pH on blood glucose determination by the glucose dehydrogenase/pyrroloquinoline quinone system (under physiologically relevant conditions of ionic strength and temperature) is not clinically significant.

Keywords: PQQ-dependent glucose dehydrogenase; basic science; capillary blood glucose; chemistry; clinical chemistry; diabetes mellitus.