Subject(s)
Blood Glucose/drug effects , Glucans/adverse effects , Glucose/adverse effects , Hypoglycemia/etiology , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Blood Glucose/analysis , Diabetes Mellitus, Type 1/complications , Glucans/therapeutic use , Glucose/therapeutic use , Humans , Hypoglycemia/prevention & control , Icodextrin , Treatment OutcomeABSTRACT
A 45-year-old female diabetes-mellitus patient on peritoneal dialysis was admitted because of vertigo. During her stay in hospital she developed a comatose condition with abnormal head posture and deviation ofthe eyes to the left. Capillary blood from the fingertip showed a glucose value of 15.4 mmol/l. However, the automatically obtained glucose value delivered with a blood-gas analysis was found to be 1.2 mmol/l. The neurological state of the patient normalised fully after intravenous glucose administration. The glucose values were falsely elevated because the patient used a peritoneal dialysis fluid at night which contained icodextrin as an osmotic agent. Metabolites of icodextrin can influence blood-glucose measurements taken using analyzers that depend on the enzyme glucose dehydrogenase. To prevent potentially life-threatening situations, the use of an adequate glucose meter is of paramount importance.