Blood glucose meters (BGM) are used extensively in hospitals, yet the staff operating these devices don’t necessarily understand all the factors that affect the results. Clinical lab professionals have a significant role to play in ensuring that their institutions and colleagues make the best use of these instruments.
To address these issues, the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) formed a work group under its POCT Committee, producing the document, How Should Glucose Meters be Evaluated for Critical Care. This document will be highlighted in the scientific session (33223) Capillary samples and best practices for blood glucose monitoring in critical care and hospitalized patients: A report on the IFCC POCT-Task Force Work Group, recent FDA activities, and CLSI POCT17. This scientific session at the 70th AACC Annual Scientific Meeting & Clinical Lab Expo in Chicago from 2:30 p.m. until 5 p.m. July 31 is worth 2.5 CE hours.
The speakers plan to cover some of the considerations and limitations of BGMs in critically ill patients and how these instruments should be evaluated, according to James Nichols, PhD, DABCC, FAACC, medical director of clinical chemistry with Vanderbilt University Medical Center. He will be discussing what factors and processes hospitals should consider in using BGM for hospitalized patients.
Hospitals should be concerned about limitations of these devices—not just analytically from their manufacturers but also physiologically. This refers to what could go wrong with this instrument from a sample perspective, Nichols said. “It’s important for hospitals to keep in mind what patient populations these devices have been validated for. Do their patients match that population, and are they stable from a perspective of physiology?” he said.
In his talk, Nichols plans to focus on the limitations and some alternatives to BGMs from the perspective of CLSI’s white paper POCT17, Use of Glucose Meters in Critically Ill Patients. He’ll also discuss the results of a study he and his colleagues did on alternative methodologies reported by the Centers for Medicare and Medicaid Services, the Food and Drug Administration, and CLSI. One such alternative is using a blood gas analyzer instead of a BGM. “We did a retrospective study of several thousand blood gas samples, and we’ll talk about those results compared to what FDA has recommended for BGM,” Nichols said.
Nichols will join three other speakers:
- Cynthia Bowman, MD, a pathologist at Baystate Health, the session’s moderator, who will introduce the IFCC document and discuss validation and verification concepts for BGM best practice with hospitalized patients and understanding BGM performance;
- Brad Karon, MD, PhD, a pathologist with Mayo Clinic, whose talk will focus on capillary glucose accuracy in critical care; and
- Dieter Mesotten, MD, PhD of Ziekenhuis Oost-Limburg, who will discuss the clinical and technical factors affecting BGM in hospitalized patients and the risks and benefits of insulin therapy.
Nichols hopes attendees will take from the session a better appreciation of the limitations of BGMs and a deeper understanding of whether their institutions are using BGMs appropriately and for the right patient populations. Don’t miss this important scientific session at the 70th AACC Annual Scientific Meeting & Clinical Lab Expo July 29–August 2 in Chicago.