The Accu-Chek Mobile blood glucose monitoring system used under controlled conditions meets ISO 15197 standards in the hands of diabetes patients.

BACKGROUND: Self-monitoring of blood glucose is a cornerstone of diabetes management. The aim of this study was to evaluate the analytical quality and the ease of use of the Accu-Chek Mobile, a new glucose monitoring system designed for capillary blood testing by diabetic patients. MATERIALS AND METHODS: The performance of the Accu-Chek Mobile was evaluated both in the hands of a scientist and of diabetes patients. The designated comparative method was a hexokinase-based laboratory method (Architect ci8200). Diabetics (N = 88) with previous experience of self-testing were recruited for the study. Patient samples, containing glucose in concentrations mainly between ˜4 and ˜20 mmol/L, were analyzed in duplicates both on the Accu-Chek Mobile and with the comparative method. The patients answered a questionnaire about the ease of use of the meter. RESULTS: The meter yields reproducible readings, with an imprecision CV <5% as required by the American Diabetes Association (ADA). Of the glucose concentrations obtained by both the scientist and the patients, more than 95% of the individual results were within ± 20% of the comparative method, meeting the ISO 15197 accuracy goal, but not the stricter ± 10% ADA goal. CONCLUSION: Accu-Chek Mobile is a user-friendly glucometer that in a normo- and hyperglycemic range fulfils the ISO 15197 accuracy requirement, also in the hands of diabetes patients.

Association of serum-soluble CD26 and CD30 levels with asthma, lung function and bronchial hyper-responsiveness at school age.

AIM: There is a need for markers of Th1 and Th2 imbalance in diseases such as asthma. CD30 is an activation marker of Th2 cells, and importance of Th1 marker CD26 was recently found in adult asthma. We studied whether serum-soluble CD30 (sCD30) or serum-soluble CD26 (sCD26) could support early diagnosis of asthma in children at school age. METHODS: sCD26 and sCD30 were measured in 34 children with clinically confirmed asthma, 31 with possible asthma and in 147 controls. In addition, the associations of flow volume spirometry, methacholine inhalation challenge and free running test results with serum sCD26 or sCD30 were analysed. RESULTS: Serum sCD30 was significantly higher in children with confirmed asthma (mean 91.5 IU/mL, SD 23.0) than in the controls (78.8 IU/mL, 25.9; p = 0.042). No significant differences were found in serum sCD26 levels between the groups. There was a negative correlation of mean mid expiratory flow values with serum sCD26 (r = -0.22, p = 0.0018). Neither methacholine inhalation challenge nor free running test results were associated with serum sCD26 or sCD30. CONCLUSION: Serum sCD30 was higher in children with asthma. However, marked overlap in serum sCD30 between asthmatic and healthy children limits the usefulness of sCD30 as a diagnostic marker of asthma.

Diagnostic, clinical and laboratory turnaround times in troponin T testing.

BACKGROUND: At present, measurements of troponins play a key role in the diagnosis of myocardial infarction. There is a consensus that a turnaround time (TAT) of 1 h or less should be achieved for cardiac marker assays. However, little is known about the real delays between the patient's arrival at the emergency department (ED) and the reporting of the test. METHODS: In the present study, the TATs of a cardiac marker, troponin T (TnT), were analyzed at a central laboratory at Kuopio University Hospital in a population consisting of 215 patients who were admitted to the hospital ED. Four specific time points were recorded: 1) the time of the patient's arrival to the ED, 2) the time of the ordering of the test, 3) the time when blood samples arrived at the laboratory, and 4) the time of completion and reporting of the test. RESULTS: The median diagnostic TAT from patient's arrival to the reporting of the TnT result was 122 min. The clinical median TAT was 46 min and the laboratory median TAT was 69 min. Laboratory TAT consisted of the preanalytical TAT at the ED (median 14 min), pre- and postanalytical TAT in the laboratory (median 40 min), and the analytical TAT (on average 10 min). The laboratory TAT was approximately half of the complete diagnostic TAT. CONCLUSIONS: On the basis of this analysis, we propose new concepts for the TATs in the diagnostic process: diagnostic TAT which consists of clinical and laboratory TAT. The focus should be shifted from the analytical TAT to the diagnostic process as a whole.