Diagnosis of hypoglycaemia: Effects of blood sample handling and evaluation of a glucose photometer in the low glucose range

Hypoglycaemia is a dangerous condition. Rapid and reliable blood glucose measurements are necessary for the initiation of treatment to reduce the risk of neurological sequelae. The aim of this study was to compare a bedside glucose photometer (HemoCue) with three methods of handling blood glucose measurements in a routine chemistry laboratory and to estimate the reliability of glucose measurements in the low glucose range during controlled hypoglycaemia. Nine children underwent an arginine-insulin tolerance test as part of a growth hormone deficiency investigation. Only blood samples below 4.0 mmol l(-1) were included (n = 35). Significant (0.3-1.0 mmol l(-1)) differences in blood glucose measurements were found, depending on the handling of the blood sample. The differences seem primarily to be due to glycolysis which occurred in spite of the addition of the glycolysis inhibitor NaF to the blood samples. Immediate centrifugation and analysis of the supernatant or immediate analysis with the HemoCue results in higher, and presumably more correct, values than routine procedures and permits a more accurate diagnosis of hypoglycaemia.