Dear colleagues

I am looking with our endocrinologist into the reliability of current glucose meters at low concentrations in adults, and hope the mail-base can save a lengthy literature search.

Our idea is to issue one to the patients at home who have reported occasional symptoms to filter out which of those with vague symptoms who should have follow-up admission for an expensive prolonged fast. This of course is to look for a possible insulinoma, rather than hypos in diabetes. It is to replace a rather dated finger prick filter paper test (are we the last to do that?).

For example, one meter the Roche Accu-check Inform II has a claimed specification down to 0.6 mmol/L. I guess other current meters claim similar. If you have any data on the real life reliability of these measurements in the range of, say 1.0 - 4.0 mmol/L (on any current meter) please can you let me know, either to me in confidence if you wish or if not direct to the mail-base. Most SOPs probably still have a get-out clause something like, glucose < 3mmol/L should be confirmed by a laboratory glucose. However that is a bit of a dogma and may not reflect true performance. Alternatively it may reflect the genuine potential hospital interferences (e.g. haematocrit in neonates or poor peripheral perfusion), less of an issue in ambulant adults.

Ideally I would like a small hand held meter with a memory that can be recalled and can't be altered by the patient (and even hidden from them if possible (sneaky!)). Any good meters for that aspect?

Regards, Steve

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