Evaluation of blood glucose levels after hepatitis B immune globulin administration utilizing two different blood glucose monitoring systems.
Academic Article
Overview
abstract
BACKGROUND: Hepatitis B Immune Globulin (HBIG) is used post liver transplantation (OLT) in hepatitis B surface antigen-positive recipients to prevent recurrence of hepatitis B. One formulation of HBIG, HepaGam B, contains the disaccharide maltose, which can potentially falsely elevate glucose readings when glucose nonspecific point of care (GNSPOC) testing is used, such as a glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ)-based method. This can result in inappropriate administration of antidiabetic agents and resultant episodes of clinically significant hypoglycemia. Glucose specific point of care (GSPOC) testing, such as a glucose oxidase-based method, however, is not affected by the presence of maltose. The purpose of this study was to determine if there was a significant difference in glucose readings using GSPOC and GNSPOC monitoring devices after HBIG administration. METHODS: This is a nonrandomized, prospective study evaluating patients receiving maintenance HBIG therapy over 3 months post liver transplantation. Blood glucose levels in each subject were analyzed by GSPOC and GNSPOC devices at specific times around HBIG administration. RESULTS: Five adult OLT recipients receiving maintenance HBIG therapy were administered HepaGam B during the regularly scheduled outpatient visits. The median difference (GNSPOC minus GSPOC) predose as well as immediately, 60 minutes, and 120 minutes postdose were: -2, 11, 6, and 0 mg/dL, respectively. A random intercept model was used to fit the five subjects' glucose reading data over time. The Meter by Time interaction effect was not significant (P = .59) and the Meter effect was not significant (P = .46), which demonstrated no statistical difference between GNS and GS readings following HBIG administration. CONCLUSIONS: Based on these results, there is not a significant difference between GSPOC and GNSPOC readings after administration of this HBIG formulation.
