Elevation of Postprandial Blood Sugar and Visible Symptoms: What Can You Do to Maintain PPS Levels?
October 15, 2022
Physical Exercise and PPS Management
October 20, 2022
Glucose monitoring, doubtlessly, has become a highly integral part of diabetes care, but there are some limitations when it comes to accuracy. Accuracy could be limited due to strip manufacturing variances, storage of strips, and lastly ageing. Accuracy may also be hampered due to limitations posed by the environment (such as altitude or temperature) or to patient factors such as incorrect coding, inaccurate handwashing, altered haematocrit, or naturally occurring substances that pose interferences. Lastly, exogenous interfering substances may lead to errors to the system evaluation of postprandial blood sugar.
Blood Glucose Monitoring
Blood glucose monitoring, many a time, has significant errors that are quite poorly understood by healthcare providers as well as patients. By comprehending the source of an error as well as the strategies of prevention and correction, healthcare providers can phenomenally help their patients to use these systems in a far more effective manner. Here, we have discussed how to successfully measure inaccuracy, the sources of errors during self-monitoring of blood glucose (SMBG), clinical testing of each system, and the ways in which some of these errors can be minimised, if not totally eliminated.
Sources of Glucose Monitoring Inaccuracy
The inaccuracy of postprandial blood glucose monitoring systems stems from four primary sources: (1) strip factors, (2) physical factors, (3) patient factors, and (4) pharmacological factors.
Strip Factors
Similar to any manufactured product, there exists a small amount of strip-to-strip variation, which will surely lead to some level of inaccuracy in postprandial blood glucose readings. When it comes to certain types of glucose strips, the individual reaction wells (or sample chambers) of strips are extremely small (2-3 mm); hence, a well-size variation of 50 μm will cause an error up to 3%. Alterations in enzyme coverage could also influence accuracy.
Physical Factors
There are numerous physical factors that can eventually influence the accuracy of blood glucose strips, the most common physical factors being temperature and altitude. Each glucose-monitoring system is studied by the manufacturer, taking into account the influence of both temperature and altitude on accuracy. That said, some clinical data exists on what hampers accuracy under extreme conditions.
Patient Factors
A patient’s ability to use their glucometer properly can greatly influence the accuracy of a blood glucose meter. Most glucometers need to be coded, although some new meters avoid coding, which determines the precise relationship between the electrical signal that is produced by the strip and the amount of blood glucose that is reported. While most manufacturers choose not to disclose the errors caused by miscoding, researchers estimate that the error for some glucometers is between 1% and 3% per miscode level.
Pharmacological Factors
Several medications can significantly alter the readings when it comes to SMBG. With electrochemical glucose oxidase systems, all appear to interact with the electrode and include ascorbic acid, tolazamide, L-dopa, and acetaminophen. The error generated from these medications is quite minor. With glucose dehydrogenase, several other sugar can pose an interference. Xylose and maltose may have a minor effect, but the substance that poses the most danger is icodextrin.
When used in the right manner, PPS (postprandial sugar) monitors are usually accurate. That said, there may occur errors occasionally.
Mentioned below are additional factors that affect their accuracy and steps to be taken to efficiently prevent or resolve the problem.
Test Strip Problems:
Chuck out outdated or damaged test strips: Store strips only in their sealed container. Make sure to keep them away from humidity and moisture. Make it a point to ensure that the strips are designed perfectly for your specific glucometer.
Extreme Temperatures:
Store your glucometer and test strips at room temperature.
Alcohol, Grime, and Other Substances on the Skin:
Prior to pricking your skin, thoroughly wash and dry your hands and the site of testing with soap and water. Refrain from using a hand sanitiser prior to testing. If you are using alcohol wipes, let the testing site dry completely prior to the pricking.
Monitor Problems:
Insert the test strip within the monitor completely. Replace the batteries used in the monitor as needed. Replace the monitor every 4-5 years.
Insufficient Amount of Blood Applied to the Strip:
Touch a sufficient drop of blood to the strip. Do not add additional blood to the test strip post application of the first drop.
Location of the Testing Site:
If you are using a testing site that is other than your fingertips, and if you feel that the reading is wrong, you should test again using fingertip as the testing site. Samples of blood from alternate sites are not as accurate as sample from the fingertips, especially when your postprandial blood sugar levels are rising and falling quickly.
The Amount of Red Blood Cells in Your Blood:
If you are experiencing dehydration or if you are anaemic (when the red blood cell count is low), your test results may tend to be less accurate.
To Sum It Up:
To ensure that your postprandial blood sugar normal range is accurate without any glitches, you must perform a few steps such as proper storing of the test strips and monitor of your blood glucose meter. You must also make it a point to draw blood samples from the fingertips. There are four factors that play a role in erroneous blood sugar readings, including strip factors, physical factors, patient factors, and pharmacological factors.
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