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Ned Tijdschr Geneeskd ; 150(28): 1574-6, 2006 Jul 15.
Article in Dutch | MEDLINE | ID: mdl-16886696

ABSTRACT

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.


Subject(s)
Autoanalysis/instrumentation , Diabetic Coma/etiology , Glucans/adverse effects , Glucose/adverse effects , Hypoglycemia/etiology , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Blood Glucose/analysis , Diabetes Mellitus, Type 1/complications , Diabetic Coma/diagnosis , Diabetic Coma/drug therapy , Female , Glucose/therapeutic use , Humans , Hypoglycemia/diagnosis , Hypoglycemia/drug therapy , Icodextrin , Middle Aged , Peritoneal Dialysis/adverse effects , Treatment Outcome
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