Assessment  of three frequently used blood glucose monitoring devices in clinical routine

Thomas Zueger; Vanessa Schuler; Christoph Stettler; Peter Diem; Emanuel R Christ

doi:10.4414/smw.2012.13631

Original article

Vol. 142 No. 2728 (2012)

Assessment of three frequently used blood glucose monitoring devices in clinical routine

Thomas Zueger
Vanessa Schuler
Christoph Stettler
Peter Diem
Emanuel R Christ

DOI: https://doi.org/10.4414/smw.2012.13631
Cite this as:: Swiss Med Wkly. 2012;142:w13631
Published: 01.07.2012

Summary

BACKGROUND: Self-monitoring of blood glucose plays an important role in the management of diabetes and has been shown to improve metabolic control. The use of blood glucose meters in clinical practice requires sufficient reliability to allow adequate treatment. Direct comparison of different blood glucose meters in clinical practice, independent of the manufactures is scarce. We, therefore, aimed to evaluate three frequently used blood glucose meters in daily clinical practice.

METHODS: Capillary blood glucose was measured simultaneous using the following glucose meters: Contour^® (Bayer Diabetes Care, Zürich, Switzerland), Accu-Chek^® aviva (Roche Diagnostics, Rotkreuz, Switzerland), Free-Style^® lite (Abbott Diabetes Care, Baar, Switzerland). The reference method consisted of the HemoCue^® Glucose 201+ System (HemoCue^® AB, Ängelholm, Sweden) with plasma conversion. The devices were assessed by comparison of the Mean Absolute Relative Differences (MARD), the Clarke Error Grid Analysis (EGA) and the compliance with the International Organization of Standardization criteria (ISO 15197:2003).

RESULTS: Capillary blood samples were obtained from 150 patients. MARD was 10.1 ± 0.65%, 7.0 ± 0.62% and 7.8 ± 0.48% for Contour^®, Accu-Chek^® and Free-Style^®, respectively. EGA showed 99.3% (Contour^®), 98.7% (Accu-Chek^®) and 100% (Free-Style^®) of all measurements in zone A and B (clinically acceptable). The ISO criteria were fulfilled by Accu-Chek^® (95.3%) and Free-Style^® (96%), but not by Contour^® (92%).

CONCLUSIONS: In the present study the three glucose meters provided good agreement with the reference and reliable results in daily clinical routine. Overall, the Free-Style^® and Accu-Chek^® device slightly outperformed the Contour^® device.

References

U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes. 1995;44:1249–58.
The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.
Haller MJ, Stalvey MS, Silverstein JH. Predictors of control of diabetes: monitoring may be the key. J Pediatr. 2004;144:660–1.
Levine BS, Anderson BJ, Butler DA, Antisdel JE, Brackett J, Laffel LM. Predictors of glycaemia control and short-term adverse outcomes in youth with type 1 diabetes. J Pediatr. 2001;139:197–203.
Strowig SM, Raskin P. Improved glycaemia control in intensively treated type 1 diabetic patients using blood glucose meters with storage capability and computer-assisted analyses. Diabetes Care. 1998;21:1694–8.
Schutt M, Kern W, Krause U, Busch P, Dapp A, Grziwotz R, Mayer I, Rosenbauer J, Wagner C, Zimmermann A, Kerner W, Holl RW. Is the frequency of self-monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centres in Germany and Austria. Exp Clin Endocrinol Diabetes. 2006;114:384–8.
Ziegler R, Heidtmann B, Hilgard D, Hofer S, Rosenbauer J, Holl R. Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes. Pediatr Diabetes. 2011;12:11–7.
Allemann S, Houriet C, Diem P, Stettler C. Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis. Curr Med Res Opin. 2009;25:2903–13.
St John A, Davis WA, Price CP, Davis TM. The value of self-monitoring of blood glucose: a review of recent evidence. J Diabetes Complications. 2010;24:129–41.
Poolsup N, Suksomboon N, Rattanasookchit S. Meta-analysis of the benefits of self-monitoring of blood glucose on glycaemia control in type 2 diabetes patients: an update. Diabetes Technol Ther. 2009;11:775–84.
International Diabetes Federation (IDF): Diabetes Atlas, 5th edition. 2011
Ginsberg BH. Factors affecting blood glucose monitoring: sources of errors in measurement. J Diabetes Sci Technol. 2009;3:903–13.
ISO 15197:2003: In vitro diagnostic test systems requirement for blood glucose monitoring systems for self-testing in managing diabetes mellitus. Geneva: World Health Organisation. 2003
American Diabetes Association. Standards of medical care in diabetes – 2011. Diabetes Care. 2011;34 Suppl 1:S11–61.
Stork AD, Kemperman H, Erkelens DW, Veneman TF. Comparison of the accuracy of the HemoCue glucose analyzer with the Yellow Springs Instrument glucose oxidase analyzer, particularly in hypoglycaemia. Eur J Endocrinol. 2005;153:275–81.
Bland MJ, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;307–10.
Clarke WL, Cox D, Gonder-Frederick LA, Carter W, Pohl SL. Evaluating clinical accuracy of systems for self-monitoring of blood glucose. Diabetes Care. 1987;10:622–8.
Self-monitoring of blood glucose. American Diabetes Association. Diabetes Care. 1994;17:81–6.
Kuo CY, Hsu CT, Ho CS, Su TE, Wu MH, Wang CJ. Accuracy and precision evaluation of seven self-monitoring blood glucose systems. Diabetes Technol Ther. 2011;13:596–600.
Tack C, Pohlmeier H, Behnke T, Schmid V, Grenningloh M, Forst T, Pfutzner A. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects. Diabetes Technol Ther. 2011
Freckmann G, Baumstark A, Jendrike N, Zschornack E, Kocher S, Tshiananga J, Heister F, Haug C. System accuracy evaluation of 27 blood glucose monitoring systems according to DIN EN ISO 15197. Diabetes Technol Ther. 2010;12:221–31.
Consensus statement on self-monitoring of blood glucose. Diabetes Care. 1987;10:95–9.
Hirose T, Mita T, Fujitani Y, Kawamori R, Watada H. Glucose monitoring after fruit peeling: pseudohyperglycaemia when neglecting hand washing before fingertip blood sampling: wash your hands with tap water before you check blood glucose level. Diabetes Care. 2011;34:596–7.
Arabadjief D, Nichols JH. Assessing glucose meter accuracy. Curr Med Res Opin. 2006;22:2167–74.
Ellison JM, Stegmann JM, Colner SL, Michael RH, Sharma MK, Ervin KR, Horwitz DL. Rapid changes in postprandial blood glucose produce concentration differences at finger, forearm, and thigh sampling sites. Diabetes Care. 2002;25:961–4.

How to Cite

1.

Zueger T, Schuler V, Stettler C, Diem P, Christ ER. Assessment of three frequently used blood glucose monitoring devices in clinical routine. Swiss Med Wkly [Internet]. 2012 Jul. 1 [cited 2024 Nov. 18];142(2728):w13631. Available from: https://smw.ch/index.php/smw/article/view/1522

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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[1] U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes. 1995;44:1249–58.

[2] The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.

[3] Haller MJ, Stalvey MS, Silverstein JH. Predictors of control of diabetes: monitoring may be the key. J Pediatr. 2004;144:660–1.

[4] Levine BS, Anderson BJ, Butler DA, Antisdel JE, Brackett J, Laffel LM. Predictors of glycaemia control and short-term adverse outcomes in youth with type 1 diabetes. J Pediatr. 2001;139:197–203.

[5] Strowig SM, Raskin P. Improved glycaemia control in intensively treated type 1 diabetic patients using blood glucose meters with storage capability and computer-assisted analyses. Diabetes Care. 1998;21:1694–8.

[6] Schutt M, Kern W, Krause U, Busch P, Dapp A, Grziwotz R, Mayer I, Rosenbauer J, Wagner C, Zimmermann A, Kerner W, Holl RW. Is the frequency of self-monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centres in Germany and Austria. Exp Clin Endocrinol Diabetes. 2006;114:384–8.

[7] Ziegler R, Heidtmann B, Hilgard D, Hofer S, Rosenbauer J, Holl R. Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes. Pediatr Diabetes. 2011;12:11–7.

[8] Allemann S, Houriet C, Diem P, Stettler C. Self-monitoring of blood glucose in non-insulin treated patients with type 2 diabetes: a systematic review and meta-analysis. Curr Med Res Opin. 2009;25:2903–13.

[9] St John A, Davis WA, Price CP, Davis TM. The value of self-monitoring of blood glucose: a review of recent evidence. J Diabetes Complications. 2010;24:129–41.

[10] Poolsup N, Suksomboon N, Rattanasookchit S. Meta-analysis of the benefits of self-monitoring of blood glucose on glycaemia control in type 2 diabetes patients: an update. Diabetes Technol Ther. 2009;11:775–84.

[11] International Diabetes Federation (IDF): Diabetes Atlas, 5th edition. 2011

[12] Ginsberg BH. Factors affecting blood glucose monitoring: sources of errors in measurement. J Diabetes Sci Technol. 2009;3:903–13.

[13] ISO 15197:2003: In vitro diagnostic test systems requirement for blood glucose monitoring systems for self-testing in managing diabetes mellitus. Geneva: World Health Organisation. 2003

[14] American Diabetes Association. Standards of medical care in diabetes – 2011. Diabetes Care. 2011;34 Suppl 1:S11–61.

[15] Stork AD, Kemperman H, Erkelens DW, Veneman TF. Comparison of the accuracy of the HemoCue glucose analyzer with the Yellow Springs Instrument glucose oxidase analyzer, particularly in hypoglycaemia. Eur J Endocrinol. 2005;153:275–81.

[16] Bland MJ, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;307–10.

[17] Clarke WL, Cox D, Gonder-Frederick LA, Carter W, Pohl SL. Evaluating clinical accuracy of systems for self-monitoring of blood glucose. Diabetes Care. 1987;10:622–8.

[18] Self-monitoring of blood glucose. American Diabetes Association. Diabetes Care. 1994;17:81–6.

[19] Kuo CY, Hsu CT, Ho CS, Su TE, Wu MH, Wang CJ. Accuracy and precision evaluation of seven self-monitoring blood glucose systems. Diabetes Technol Ther. 2011;13:596–600.

[20] Tack C, Pohlmeier H, Behnke T, Schmid V, Grenningloh M, Forst T, Pfutzner A. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects. Diabetes Technol Ther. 2011

[21] Freckmann G, Baumstark A, Jendrike N, Zschornack E, Kocher S, Tshiananga J, Heister F, Haug C. System accuracy evaluation of 27 blood glucose monitoring systems according to DIN EN ISO 15197. Diabetes Technol Ther. 2010;12:221–31.

[22] Consensus statement on self-monitoring of blood glucose. Diabetes Care. 1987;10:95–9.

[23] Hirose T, Mita T, Fujitani Y, Kawamori R, Watada H. Glucose monitoring after fruit peeling: pseudohyperglycaemia when neglecting hand washing before fingertip blood sampling: wash your hands with tap water before you check blood glucose level. Diabetes Care. 2011;34:596–7.

[24] Arabadjief D, Nichols JH. Assessing glucose meter accuracy. Curr Med Res Opin. 2006;22:2167–74.

[25] Ellison JM, Stegmann JM, Colner SL, Michael RH, Sharma MK, Ervin KR, Horwitz DL. Rapid changes in postprandial blood glucose produce concentration differences at finger, forearm, and thigh sampling sites. Diabetes Care. 2002;25:961–4.