Hélène Bihan, MD; Marinos Fysekidis, MD; Viorica Harbuz, MD; G. Reach, MD, PhD; Régis Cohen, MD, PhD
Potential Conflicts of Interest: Drs. Bihan and Reach have received payment from Sanofi Aventis and Novo Nordisk for expert testimony.
Bihan H, Fysekidis M, Harbuz V, Reach G, Cohen R. False-Positive Blood Glucose and Ketone Values With Lightening Cream. Ann Intern Med. 2011;155:649. doi: 10.7326/0003-4819-155-9-201111010-00023
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Published: Ann Intern Med. 2011;155(9):649.
Background: The Precision Xceed Pro system (Abbott Laboratories, Abbott Park, Illinois) has made it easier for clinicians to evaluate and monitor patients for ketoacidosis by measuring both blood glucose and ketone at the point of care by using fingerstick blood (1).
Objective: To report a new cause of false-positive results with the Precision Xceed Pro system.
Case Report: Emergency physicians diagnosed moderate ketoacidosis in a 53-year-old black woman from the Democratic Republic of Congo who had received a diagnosis of type 2 diabetes 5 years previously. When she came to our emergency department, the patient was taking 2 oral antidiabetes medications and had a plasma glucose level of 16 mmol/L (288.29 mg/dL), plasma bicarbonate level of 18 mmol/L, and blood pH of 7.36. The physicians started basal and bolus insulin therapy and admitted her to the hospital, where the ketoacidosis disappeared in 24 hours with normalization of plasma bicarbonate levels. Blood glucose levels measured with the Precision Xceed Pro system remained around 15 mmol/L (270.28 mg/dL). We measured blood ketones daily as recommended (2) and found surprisingly high levels (3 to 6 mmol/L; normal values <0.3 mmol/L), although her urine ketones remained negative.
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