Galactose, Maltose, and Xylose Products May Falsely Elevate Glucose Results - Update
August 24, 2011
Due to increasing reports of fatal hypoglycemic events, FDA recommends that all healthcare facilities avoid the use of glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) glucose test strips. Parenteral agents containing galactose or maltose and oral agents containing d-Xylose can interfere with GDH-PQQ blood glucose testing, resulting in falsely elevated values. Multiple fatal hypoglycemic events associated with this interaction have been reported to the FDA since 1997, many within the last few years.
FDA recommends using laboratory-based glucose testing for patients receiving d-xylose, Extraneal (icodextrin 7.5% with electrolytes peritoneal dialysis solution), Octagam 5%, WinRho SDF liquid, HepaGamB, Orencia (abatacept), Adept adhesion reduction solution (4% icodextrin), BEXXAR radioimmunotherapy agent, or any other product containing or metabolized to a non-glucose sugar. Other recommendations include determining possible interacting products upon patient admission, computerized drug-interaction alerts, and periodic laboratory-based glucose testing in all patients.
Laboratory-based testing and other glucose testing systems including glucose dehydrogenase nicotine adenine dinucleotide (GDH-NAD), glucose dehydrogenase flavin adenine dinucleotide (GDH-FAD), and glucose oxidase methods are not affected by non-glucose sugars and do not provide falsely elevated values. See the link below for a list of GDH-PQQ glucose test strips.
Note for clinicians at University of Utah Health Care: Glucose meters which use GDH-PDQ test strips include the Roche Diagnostics Accu-Chek product line. In the past, many areas in our health system used Roche glucose test meters. However, our health system has now transitioned to new glucose test meters in all inpatient and outpatient areas. The new glucose test meters do not interact with point of care glucose GDH-PDQ test strips. Point of care glucose testing may be safely performed in our health system.
Additional information is available at the following links:
- Roche Diagnostics List of Interacting Products
- MedWatch Alert:
- FDA Safety Information:
- Final FDA Report:
- Public Health Notification:
- List of GDH-PQQ Glucose Test Strips (as of August 2009):
- Advice for Patients:
August 24, 2011; August 12, 2011; August 27, 2010; August 14, 2009; August 21, 2006; November 14, 2005; University of Utah, Drug Information Service. Copyright 2011, Drug Information Service, University of Utah, Salt Lake City, UT.