This review will summarize the details of measurement techniques and potential interferences that may alter these measurements to provide background for the subsequent discussion of device accuracy. The accuracy of glucose monitoring depends on many aspects, including the device measurement mechanism, sample source and collection, and patient attributes. This article reviews the accuracy and limitations of current point-of-care glucose monitoring devices (POCGMDs). 3– 7 The accuracy of the BG measurements plays an important role for treatment decisions when aiming for glycemic control. 2 Glycemic control using an insulin infusion in critically ill patients requires frequent and rapid BG monitoring with devices available for bedside use. 1 Control of blood glucose (BG) in an acceptable range remains a target for diabetes patients in both the hospital and outpatient environments. The prevalence of diabetes mellitus continues to increase with approximately 12.9% of the population in the United States diagnosed with diabetes and an even larger portion (29.5%) estimated to be living in a prediabetic state. This review will discuss potential interferences and shortcomings of the current POCGMDs and stress when these may impact the reliability of POCGMDs for clinical decision-making. This issue raises serious safety concerns and the importance of understanding the limitations of POCGMDs. In general, currently available POCGMDs exhibit the greatest accuracy within the range of physiological glucose levels but become less reliable at the lower and higher ranges of BG levels. These elements alone or when combined can significantly impact BG measurement accuracy with POC glucose monitoring devices (POCGMDs). Patient parameters capable of influencing measurements include variations in pH, blood oxygen, hematocrit, changes in microcirculation, and vasopressor therapy. The accuracy of the POC glucose monitor depends on device methodology and other factors, including sample source and collection and patient characteristics. This review focuses on the state of point-of-care (POC) glucose monitoring and the accuracy of the measurement devices. Control of blood glucose (BG) in an acceptable range is a major therapy target for diabetes patients in both the hospital and outpatient environments.
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