Peritoneal Dialysis and interference from Extraneal
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Tuesday, March 28, 2006 |
Q: "My daughter’s doctor wants to put her on a peritoneal dialysis solution called Extraneal®. When I called customer service, I was told that there would be interference which would cause the FreeStyle® meter to read falsely high. Would you please elaborate?"
A: That is correct. As you probably already know, peritoneal dialysis involves injecting fluid into the peritoneal space for 8-16 hours in order to pull off the excess contaminants that the kidneys can't excrete.
The FreeStyle test strip package insert states: "Intravenous therapy solutions such as some immunoglobulin preparations and peritoneal dialysis solutions containing icodextrin or compounds of Galactose = 13 mg/dL or Maltose = 20 mg/dL may cause overestimation of blood glucose results."
Peritoneal Dialysis involves the use of a Peritoneal Dialysis Solution, Extraneal, made by Baxter®, and Extraneal is icodextrin. In the body, icodextrin breaks down to maltose. So, there is a risk that your daughter would get falsely elevated results when using the FreeStyle strip if she were undergoing peritoneal dialysis.
Please note that this is due to an enzyme used in the FreeStyle strip: PQQ-GDH, also known as glucose dehydrogenase, which reacts with maltose. The more commonly used enzyme, glucose oxidase (also known as GOx) does not react with maltose.
So when switching to another meter, please be sure to check to insure that PQQ-GDH is not the enzyme used in that strip as well. The best way to check would be to first ask your daughter's doctor and/or diabetes educator to read the test strip package insert as well as to call the glucose meter company directly for final confirmation.
Note that the Precision Xtra™ system uses a different enzyme, PQQ-NAD, that is not affected by maltose, so, of the Abbott meters, the Precison Xtra system would be indicated for a person in this situation.
Related Links
U.S. Food and Drug Administration
http://www.fda.gov
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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