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Accuracy Evaluation of the Alternative Site Blood Glucose Test Using Error Grid

에러그리드를 사용한 대체부위 혈당검사의 유용성 검증

  • Park, Kyung-Soon (Department of Nursing, Munkyung College) ;
  • Cha, Eun-Jong (Biomedical Engineering Department, School of Medicine, Chungbuk National University)
  • Received : 2010.10.19
  • Accepted : 2011.01.17
  • Published : 2011.02.28

Abstract

Blood glucose information is important for self regulation in daily life, but the frequency of self test remains to be only 17%(9 tests/month) in Korea, mainly due to pain during blood sampling. The present study tried to validate the clinical efficacy of the forearm as an alternative sampling site with minimized pain. Capillary blood was sampled both on the index finger($G_F$) and the forearm($G_A$), immediately followed by glucose measurements in 531 subjects, 25 who visited the Health Enhancement Center of C University Hospital, then venous blood($G_V$) was sampled for glucose test. The blood glucose concentration measured on the forearm was closer to the venous glucose than on the finger. The mean difference between $G_V$and $G_F$ was only 10 mg/dL well within the internationally accepted error limit. Error grid analyses of $G_F-G_V$, $G_A-G_V$ and $G_A-G_F$ revealed that the number of data points in regions A and B took 100%, 99.8%, and 97.9%, respectively. These results demonstrate the forearm blood glucose test is not only accurate but also clinically valid. Therefore, the forearm blood glucose test can be a useful way of self managing the chronic diabetes with minimized sampling pain.

Keywords

References

  1. Korea Center for Disease Control and Prevention, Korea National Health & Nutrition Examination Survey, The 3rd report in depth analysis of survey result: Examination division, Seoul, Korea Center for Disease Control and Prevention, 2007.
  2. Korea National Statistical Office, Annual report on the cause of death statistics (Based on vital registration), Seoul, Korea National Statistical Office, 2006.
  3. Korean Diabetes Association, Diabetics. 2nd ed., Seoul, Korea Medical Book Company, 2006, pp. 303-308.
  4. J.K. Kim, "Self monitoring blood glucose and oral glucose tolerance test," Clinical Diabetes, vol. 1, no. 2, pp. 109-113, 2000.
  5. J.S. Skyler, "Self-monitoring of blood glucose," Med. Clin. North Am., vol. 66, no. 4, pp. 1227-1250, 1993.
  6. S. Lim, D.J. Kim, I.K. Jeong, H.S. Son, C.H. Chung, G.P. Koh, D.H. Lee, K.C. Won, J.H. Park, T.S. Park and J.H. Ahn, "A Nationwide Survey about the Current Status of Glycemic Control and Complications in Diabetic Patients in 2006," Korean Diabetes J, vol. 33, no. 1, pp. 48-57, 2009. https://doi.org/10.4093/kdj.2009.33.1.48
  7. S.W. Park, D.J. Kim, J.Y. Kim, H.Y. Kim, K.W. Min, S.H. Baek, et al. "Current status of diabetes management in Korea using national insurance database," in Korean Diabetes Association 19th Spring Meeting, 2006, pp. 227-228.
  8. R.M. Cowett and L. D'Amico, "Capillary(Heelstick) versus venous blood sampling for the determination of glucose concentration in the neonate," Biol Neonate, vol. 62, pp. 32-36, 1992. https://doi.org/10.1159/000243850
  9. D.P. Barker and N. Rutter, "Exposure to invasive procedures in neonatal intensive care unit admissions," Arch Dis Childhood, vol. 72, pp. 48-49, 1995. https://doi.org/10.1136/adc.72.1.48
  10. D.D. Cunningham, T.P. Henning, E.B. Shain, D.F. Young, T.A. Elstrom, E.J. Taylor, S.M. Schroder, P.M. Gatcomb, and W.V. Tamborlane, "Vacuum-assisted lancing of the forearm: an effective and less painful approach to blood glucose monitoring," Diabetes Technology & Therapeutics, vol. 2, pp. 541-548, 2000. https://doi.org/10.1089/15209150050501952
  11. M.S. Park, K.S. Park, K.A. Kim, M.H. Jun, T.I. Kim, T.S. Lee, and E.J. Cha, "Vacuum Assisted Auto-Lancing Technique for Capillary Blood Sampling on the Forearm with Minimized Pain," J. Biomed Eng. Res., vol. 25, no. 6, pp. 557-563, 2004.
  12. T.K. Koschinsky, L. Jungheim, Heinemann, "Glucose sensors and the alternate site testing-like phenomenon: relationship between rapid blood glucose changes and glucose sensor signals," Diabetes Technology & Therapeutics, vol. 5, no. 5, pp. 829-42, 2003. https://doi.org/10.1089/152091503322527030
  13. S.S. Greenhalgh, C.M. Bradshaw, and D.A. Hall, "Forearm blood glucose testing in diabetes mellitus," Arch. Dis. Child, vol. 89, pp. 516-518, 2004. https://doi.org/10.1136/adc.2002.019307
  14. W.L. Clarke, D. Cox, L.A. Gonder-Frederrick, W. Carter, and S.L. Pohl, "Evaluation Clinical Accuracy of Systems for Self-Monitoring of Blood Glucose," Diabetes Care, vol. 10, no. 5, pp. 622-628, 1987. https://doi.org/10.2337/diacare.10.5.622
  15. I.H. Shin, H.W. Lim, Sample size estimation in clinical trials using excel program, Seoul, Korea, Gunja Publishers, 2009.
  16. S.W. Lee, S.S. Chun, S.J. Oh, J.T. Woo, S.W. Kim, J.W. Kim, Y.S. Kim, J.Y. Pang, G.P. Go, and H.H. Nam, "Clinical benefit of forearm glucose testing in diabetes patients," Korean Endocrine Society, vol. 21, no. 4, pp. 281-289, 2006. https://doi.org/10.3803/jkes.2006.21.4.281
  17. W.L. Clarke, S. Anderson, L. Farhy, M. Breton, L.G. Frederick, D. Cox, and B. Kovatchev, "Evaluating the Clinical Accuracy of Two Continuous Glucose Sensors Using Continuous Glucose-Error Grid Analysis," Diabetes Care, vol. 28, no. 10, pp. 2412-2417, 2005. https://doi.org/10.2337/diacare.28.10.2412
  18. A.J. Brenneman and D.G. Purcell, Vacuum assisted lancing device, U.S. Patent No. 6,152,942, 2000.
  19. D.K. Kim, J.H. Won, N.P. Sergey, V.M. Viacheslav, and E.C. Evgenii. "Basic investigation for the non-invasive measurement of blood glucose concentrations by millimeter waves," IEEK Journal(SC), vol. 42, no. 1, pp. 3-6, 1998.
  20. R.W. Waynant, and V.M, Chenault, "Overview of non-invasive fluid glucose measurement using techniques to maintain glucose control in diabetes millitus," LEOS newsletter, vol. 12, no. 2, pp. 3-6, 1998.
  21. J.Y. Choi, "A comparison on the degree of pain according to methods of blood sugar test between DM Patients and healthy group," J Korean Acad Nurs, vol. 33, no. 7, pp. 928-935, 2003. https://doi.org/10.4040/jkan.2003.33.7.928

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