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Comparison of the accuracy of the hemocue glucose analyzer with the Yellow Springs Instrument glucose oxidase analyzer, particularly in hypoglycemia

Department of Internal Medicine and Metabolic Diseases and ¹ Department of Clinical Chemistry, University Medical Center Utrecht, Utrecht, The Netherlands and ² Department of Internal Medicine, Twenteborg Hospital, Almelo, The Netherlands

(Correspondence should be addressed to A D M Stork, University Medical Center Utrecht, Department of Internal Medicine and Metabolic Diseases, 31 Puttershof, 3451 LC Vleuten, The Netherlands; Email: adm.stork{at}hccnet.nl)

Objective: We aimed to assess the accuracy of the HemoCue Beta-glucose analyzer (HemoCue) and its correlation with the Yellow Springs Instrument (YSI 2300 STAT; YSI) glucose oxidase analyzer, in particular for hypoglycemic values.

Design and methods: Samples were taken from 24 volunteers during hyperinsulinemic glucose clamp studies. Glucose concentrations were determined immediately with the HemoCue in whole blood and with the YSI in plasma from the same sample. After correction for the difference between whole blood and plasma, the paired plasma glucose concentrations were analyzed with various statistical methods.

Results: A total of 500 paired glucose values were obtained, 209 of which were in the hypoglycemic range. Mean±S.E. values were 4.85±0.004 mmol/l for the HemoCue (range 1.87–16.17) and 4.81±0.004 mmol/l for the YSI (range 1.88–15.00; P = 0.80). In the hypoglycemic region, values were 3.26±0.004 mmol/l for the HemoCue (range 1.87–5.17) and 3.22±0.003 mmol/l for the YSI (range 1.88–4.20; P = 0.59). Regression analyses were HemoCue = 1.019(YSI) –0.0577 mmol/l, with r = 0.9787 for all values; for hypoglycemic values the HemoCue = 1.1169(YSI) –0.3393 mmol/l, with r = 0.8798. Using Altman’s residual plot, the difference was 0.03±0.0009 mmol/l, with 18 (3.6%) paired values outside the 95% limits of agreement (–0.82 to 0.89 mmol/l). In the hypoglycemic range, the difference was 0.04±0.001 mmol/l, with six (2.9%) values outside the 95% limits of agreement (–0.71 to 0.79 mmol/l). In error grid analysis, one value was in zone D (0.2%) and five values (1%) were in zone B; 98.8% were within zone A.

Conclusions: Determination of glucose with the HemoCue system had very good correlation with the YSI system in a broad range of glycemia and also for hypoglycemic values. We believe that these methods can be used interchangeably for research and clinical purposes in adults.