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  • Erroneously elevated glucose values due to maltose interference in mutant glucose dehydrogenase pyrroloquinolinequinone (mutant GDH-PQQ) based glucometer

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Reminder of important clinical lesson
CASE REPORT
Erroneously elevated glucose values due to maltose interference in mutant glucose dehydrogenase pyrroloquinolinequinone (mutant GDH-PQQ) based glucometer
  1. Partha Pratim Chakraborty1,
  2. Shinjan Patra1,
  3. Rana Bhattacharjee2,
  4. Subhankar Chowdhury2
  1. 1Department of Medicine, Midnapore Medical College and Hospital, Midnapore, India
  2. 2Department of Endocrinology and Metabolism, IPGMER/SSKM Hospital, Kolkata, India
  1. Correspondence to Dr Partha Pratim Chakraborty, docparthapc{at}yahoo.co.in

Summary

Currently available glucose test strip enzymes include glucose oxidase (GOD) and glucose dehydrogenase (GDH). In GDH-based glucometers, glucose oxidation can be catalysed by different cofactors: nicotinamide adenine dinucleotide (GDH-NAD), flavin adenine dinucleotide (GDH-FAD), pyrroloquinolinequinone (GDH-PQQ) and mutant GDH-PQQ. GOD-based and GDH-NAD-based glucometers are substrate-specific and do not react with sugars other than glucose. GDH-FAD reacts with xylose only in addition to glucose. GDH-PQQ is not glucose-specific; in addition to glucose, it reacts with different other sugars and produces falsely high values of capillary glucose in the presence of such substances. There are reports of several deaths associated with usage of GDH-PQQ-based test strips. A modified form of GDH-PQQ, the so-called mutant GDH-PQQ, is supposedly free from such interferences. In this article spuriously high glucose values due to maltose interference in a glucometer using the mutant GDH-PQQ chemistry are being reported.

  • Emergency medicine
  • Diabetes
  • General practice / family medicine
  • Adult intensive care
  • Nursing

https://doi.org/10.1136/bcr-2017-219928

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    Footnotes

    • Contributors PPC and SP were involved in managing the patient, literature search and preparing the manuscript. RB and SC were involved in literature search, preparing the manuscript and providing intellectual inputs.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.