Risky Delay of Hypoglycemia Detection by Glucose Monitoring at the Arm
- Karsten Jungheim and
- Theodor Koschinsky, MD
- Clinical Department, German Diabetes Research Institute, Heinrich-Heine University of Duesseldorf, Duesseldorf, Germany
Several devices for self-monitoring of blood glucose (SMBG) (e.g., AtLast, Amira; OneTouch Ultra, LifeScan; FreeStyle, TheraSense, Alameda, CA; Glucometer-Elite XL+Microlet-Vaculance, Bayer; and Sof-Tact, Abbott) recently received Food and Drug Administration approval for alternative site monitoring of capillary blood glucose. These alternatives are marketed with considerable efforts under the assumption that capillary blood glucose measurements, e.g., those taken at the forearm, do not differ from the results obtained by classic finger pricking. Diabetic patients using different devices for SMBG reported discrepancies between clinical symptoms of hypoglycemia and normoglycemic SMBG values at the forearm. Neither standardized quality control assessments of technical performance of such SMBG devices (1,2) nor patient device handling resulted in any obvious explanation of the reported discrepancies. Because of this, we examined …
