Enzymatic quantification of 1,5-anhydro-D-glucitol: evaluation and clinical application.

We investigated an enzymatic colorimetric procedure for quantification of plasma 1,5-anhydro-D-glucitol (AG) with respect to its reproducibility and application for evaluation of diabetes mellitus. Assay specificity is critically dependent on the two-layer ion-exchange column chromatography procedure to remove glucose from the sample. For female nondiabetic subjects (n = 110, ages 22-36 years) the median plasma AG concentration was 143 mumol/L (range 70-209 mumol/L); there was no relation to body mass index (BMI), fasting plasma glucose, or insulin, but an inverse association was noted for age. For a group of older subjects (n = 69, 70-85 years), no association between AG concentrations and sex, age, BMI, or various medical conditions was found. In diabetic subjects (n = 170) a significant inverse nonlinear relation existed between plasma AG and glycohemoglobin (GHb) such that at GHb > 8.5%, AG concentrations were typically < 50 mumol/L. The findings confirm that plasma AG, in the presence of normal renal function, is a reliable marker for hyperglycemia.

Computer based quality assessment of hospital capillary blood glucose monitoring.

A quality control (QC) programme to continually monitor the reliability of hospital ward capillary blood glucose levels has been developed based on a memory blood glucose meter interfaced to a portable microcomputer. Over a 38-week period some 12,500 ward QC tests were performed by approximately 200 accredited operators. Although the mean weekly coefficients of variation were all less than 15%, there was a marked variation between wards, with the frequency of testing of patients the major factor influencing reliability. However an external laboratory-based QC programme suggested a high degree of proficiency which was not achieved by any ward on internal QC assessment.