Hostname: page-component-7479d7b7d-t6hkb Total loading time: 0 Render date: 2024-07-09T12:07:03.975Z Has data issue: false hasContentIssue false

Effects of Dynamic Temperature and Humidity Stresses on Point-of-Care Glucose Testing for Disaster Care

Published online by Cambridge University Press:  08 April 2013

Abstract

Objective: To characterize the performance of glucose meter test strips using simulated dynamic temperature and humidity disaster conditions.

Methods: Glucose oxidase- and glucose dehydrogenase-based test strips were dynamically stressed for up to 680 hours using an environmental chamber to simulate conditions during Hurricane Katrina. Paired measurements vs control were obtained using 3 aqueous reagent levels for GMS1 and 2 for GMS2.

Results: Stress affected the performance of GMS1 at level 1 (P <. 01); and GMS2 at both levels (P <. 001), lowering GMS1 results but elevating GMS2 results. Glucose median-paired differences were elevated at both levels on GMS2 after 72 hours. Median-paired differences (stress minus control) were as much as −10 mg/dL (range, −65 to 33) at level 3 with GMS1, with errors as large as 21.9%. Glucose median-paired differences were as high as 5 mg/dL (range, −1 to 10) for level 1 on GMS2, with absolute errors up to 24.4%.

Conclusions: The duration of dynamic stress affected the performance of both GMS1 and GMS2 glucose test strips. Therefore, proper monitoring, handling, and storage of point-of-care (POC) reagents are needed to ensure their integrity and quality of actionable results, thereby minimizing treatment errors in emergency and disaster settings.

(Disaster Med Public Health Preparedness. 2012;6:232–240)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Kost, GJTran, NKTuntideelert, MKulrattanamaneeporn, SPeungposop, N.Katrina, the tsunami, and point-of-care testing: optimizing rapid response diagnosis in disasters. Am J Clin Pathol. 2006;126 (4):513520.Google Scholar
2.Cefalu, WTSmith, SRBlonde, LFonseca, V.The Hurricane Katrina aftermath and its impact on diabetes care: observations from “ground zero”: lessons in disaster preparedness of people with diabetes. Diabetes Care. 2006;29 (1):158160.Google Scholar
3.Haller, MJShuster, JJSchatz, DMelker, RJ.Adverse impact of temperature and humidity on blood glucose monitoring reliability: a pilot study. Diabetes Technol Ther. 2007;9 (1):19.Google Scholar
4.King, JMEigenmann, CAColagiuri, S.Effect of ambient temperature and humidity on performance of blood glucose meters. Diabet Med. 1995;12 (4):337340.Google Scholar
5.Louie, RFSumner, SLBelcher, SMathew, RTran, NKKost, GJ.Thermal stress and point-of-care testing performance: suitability of glucose test strips and blood gas cartridges for disaster response. Disaster Med Public Health Prep. 2009;3 (1):1317.Google Scholar
6.Bamberg, RSchulman, KMacKenzie, MMoore, JOlchesky, S.Effect of adverse storage conditions on performance of glucometer test strips. Clin Lab Sci. 2005;18 (4):203209.Google Scholar
7.O’Malley, JJUlmer, RW.Thermal stability of glucose oxidase and its admixtures with synthetic polymers. Biotechnol Bioeng. 1973;15 (5):917925.Google Scholar
8.Zoldák, GZubrik, AMusatov, AStupák, MSedlák, E.Irreversible thermal denaturation of glucose oxidase from Aspergillus niger is the transition to the denatured state with residual structure. J Biol Chem. 2004;279 (46):4760147609.Google Scholar
9.Gouda, MDSingh, SARao, AGAThakur, MSKaranth, NG.Thermal inactivation of glucose oxidase: mechanism and stabilization using additives. J Biol Chem. 2003;278 (27):2432424333.Google Scholar
10.Ye, W-NCombes, D.The relationship between the glucose oxidase subunit structure and its thermostability. Biochim Biophys Acta. 1989;999 (1):8693.Google Scholar
11.Geiger, OGörisch, H.Reversible thermal inactivation of the quinoprotein glucose dehydrogenase from Acinetobacter calcoaceticus: Ca2+ ions are necessary for re-activation. Biochem J. 1989;261 (2):415421.Google Scholar
12.O’Leary, JP.If not Charity Hospital, then an equivalent facility is imperative. J Natl Med Assoc. 2007;99 (5):585588.Google Scholar
13.Katrina's death: who's to blame. The Economist. 2007;13:35.Google Scholar
14.CBC News. Bitter winter a killer in Afghanistan. www.cbc.ca/news/world/story/2008/02/10/winter-afghanistan.html. Accessed June 1, 2011.Google Scholar
15.Barkemeyer, BM.Practicing neonatology in a blackout: the University Hospital NICU in the midst of Hurricane Katrina: caring for children without power or water. Pediatrics. 2006;117 (5, pt 3):S369S374.Google Scholar
16.Bernard, MMathews, PR.Evacuation of a maternal-newborn area during Hurricane Katrina. MCN Am J Matern Child Nurs. 2008;33 (4):213223.Google Scholar
17.Vanholder, RBorniche, DClaus, S, et alWhen the earth trembles in the Americas: the experience of Haiti and Chile 2010. Nephron Clin Pract. 2011;117 (3):c184c197.Google Scholar
18.Ferguson, WJLouie, RFYu, JNSumner, SLKost, GJ.Dynamic temperature and humidity profiles for assessing the suitability of point-of-care testing during emergencies and disasters.In: Proceedings of the 2011 American Association for Clinical Chemistry Annual Meeting. Atlanta, Georgia. Abstract D-20, p A155. http://www.aacc.org/events/annualmtgdirectory/Documents/AACC_11_Abstract-A149-A160.pdf. Accessed July 15, 2011.Google Scholar