Evaluation of Fingerstick Blood Glucose in Hypotensive Patients Dong Wun Shin, M.D., Jun Sig Kim, M.D., Seung Baik Han, M.D., Jun Hee Lee, M.D., Ah Jin Kim, M.D., Ji Hye Kim, M.D., Woong Khi, M.D., Sung Tae Ahn, M.D., Yong Joo Lee, M.D. 1, and Kwang Je Baek, M.D. P u r p o s e: Due to its rapidity and easy accessibility, the fingerstick blood glucometer has been used in almost all hospitals and private clinics, and even by patients themselves. We also have used it even in shock patient care, but shock shows global tissue hypoperfusion, especially in peripheral tissue. The changes of peripheral circulation have an influence on the results for fingerstick glucose. To evaluate the accuracy of the glucometer for patients with poor peripheral perfusion, we designed this s t u d y. M e t h o d s: A prospective, nonrandomized comparison group study was done. A hypotensive group and a normotensive group were compared. We obtained three data from each patient: venous blood glucose level (clinicopathologic laboratory), venous blood glucose level (by glucometer) and fingerstick glucose level (by g l u c o m e t e r ). R e s u l t s: We saw a significant difference between the fingerstick glucometer results and the laboratory glucose levels in hypotensive patients: 131.6755.33 mg/dl vs. 1 4 7. 2 362.06 mg/dl (paired t-test, p<0.05). There was no significant difference between fingerstick and laboratory glucose in normotensive patients: 101.7520.14 mg/dl vs. 1 0 5. 6 021.95 mg/dl (paired t-test, p>0.05). There was no significant difference between the results of venous glucometer and laboratory test in either group: 142.37 61.27 mg/dl vs. 147.2362.06 mg/dl (paired t-test, p>0.05) and 102.9817.02 mg/dl vs. 105.6021.95 mg/dl (paired t-test, p>0.05). Although some statistical differences existed between the results, all of the error rates were in an acceptable range (within 15%, accepted by American Diabetes Association consensus). C o n c l u s i o n: These results suggest that the blood glucose level of the glucometer with venous blood is more accurate than that with peripheral blood in patients with poor peripheral circulation. Key Words: Shock, Glucometer Department of Emergency Medicine, Inha University Medical School, Incheon, Korea Department of Emergency Medicine, Seoul Adventist Hospital, Seoul, Korea 1 73
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