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Measurement Accuracy of Blood Glucose Test on the Forearm

전완 부위 혈당검사의 정확도 분석

  • Park, Kyung-Soon (Department of Nursing, Munkyung College) ;
  • Song, Yeon-Yi (Department of Nursing, Munkyung College) ;
  • Park, Mi-Sook (Biomedical Engineering Department, School of Medicine, Chungbuk National University) ;
  • Kim, Kyoung-Oak (Seoul Asan Medical Center) ;
  • Choi, Seong-Su (Biomedical Engineering Department, School of Medicine, Chungbuk National University) ;
  • Kim, Kyung-Ah (Biomedical Engineering Department, School of Medicine, Chungbuk National University) ;
  • Ryu, Jae-Duck (Cheongju St. Mary's Hospital) ;
  • Cha, Eun-Jong (Biomedical Engineering Department, School of Medicine, Chungbuk National University)
  • 박경순 (문경대학 간호과) ;
  • 송연이 (문경대학 간호과) ;
  • 박미숙 (충북대학교 의과대학 의공학교실) ;
  • 김경옥 (서울아산병원 간호부) ;
  • 최성수 (충북대학교 의과대학 의공학교실) ;
  • 김경아 (충북대학교 의과대학 의공학교실) ;
  • 류재덕 (청주성모정형외과) ;
  • 차은종 (충북대학교 의과대학 의공학교실)
  • Published : 2009.09.30

Abstract

The present study aimed to evaluate the accuracy of the blood glucose test with almost painless vacuum assisted auto-lancing technique. The blood glucose concentration measurements in the capillary blood sampled from the alternative (forearm) site were compared with the standard venous or finger sampling techniques. Capillary blood was sampled from both the left index finger and the forearm, followed by the venous blood sampling in 531 patients who visited the C University Hospital. Blood sugar test was performed for each blood samples for comparative analysis. Mean blood glucose concentration measured on the forearm was closer to the venous glucose level than that of the finger, but the difference was approximately 10 mg/dL small enough to ignore from the clinical point of view. The correlation coefficients of the measured blood glucose levels between finger and vein and between forearm and vein were 0.94 and 0.92, respectively (p<0.001). The blood glucose measurement on the forearm also well correlated with the finger, showing a correlation coefficient of 0.94, and both data were very much close to each other. Therefore, the blood sugar test on the alternative capillary blood sampling site such as forearm was accurate enough for clinical practice. The vacuum assisted auto-lancing technique on the alternative site would be of particular interest for the disease management of the chronic diabetes, since it induces almost no pain when sampling blood from the capillaries.

통증이 거의 없는 새로운 모세혈액 채혈기법인 진공자동채혈법(vacuum assisted auto-lancing)의 정확도를 분석하고자 전형적인 대체부위인 전완(팔) 부위에서 채혈하여 측정한 혈당값을 표준 채혈부위인 정맥 및 손가락에서 채혈하여 측정한 혈당값과 비교, 분석하는 연구를 수행하였다. C대학교병원을 내원한 531명의 환자들을 대상으로 왼손 집게손가락 끝과 왼쪽 전완 부위에서 말초혈액의 혈당을 측정하였고, 곧바로 정맥 채혈하여 혈당을 측정하였다. 전완 부위 혈당 평균값이 손가락보다 정맥 혈당값에 더욱 가까웠으나 이들 간의 차이는 약 10 mg/dL 범위에 불과하여 임상적으로는 동일한 값들로 볼 수 있었다. 측정값들 간에 상관분석을 수행한 결과 손가락과 정맥 채혈의 혈당값 간의 상관계수는 0.94, 전완 부위와 정맥 혈당값 간의 상관계수는 0.92, 또한 전완 부위와 손가락 채혈 간의 상관계수는 0.94로 모두 매우 유의한 상관관계를 보였다(p<0.001). 따라서 대체부위인 전완 부위 혈당검사의 정확도가 실험적으로 입증되었다. 손가락 혈당검사는 상당한 채혈 통증이 수반되어 당뇨 환자들이 자가 검사를 기피하는 주요 원인이 되지만, 전완 부위에서 진공자동채혈하면 통증이 거의 없으므로 만성 당뇨환자들의 자가 질환관리를 위해 매우 유용하리라 기대된다.

Keywords

References

  1. 김영건, 김응진, 신순현, "한국인 당뇨병의 역학적 연구", 대한당뇨병학회, 제3권, 제1호, pp. 34-72, 1976.
  2. National Health Insurance Corporation, "Annual statistics of Health insurance" National Health Insurance Corporation, Korea, 2002.
  3. 대한당뇨병학회, "당뇨병학", 제2판, 고려의학, pp.303-308, 2006.
  4. J. S. Skyler, "Self-monitoring of blood glucose" Med. Clin. North Am., Vol. 66(4), pp. 1227-1250, 1993.
  5. 박석원, 김대중, 김재용, 김화영, 민경완, 백세현, 박이병, 박정현, 손현식, 안철우, 오지영, 이준영, 정춘희, 최경묵, "전국표본조사에 의한 우리나라 당뇨병 관리실태", 제 19차 당뇨병학회 춘계학술대회, pp.227-228, 2006.
  6. 최자윤, "당뇨환자와 일반인의 혈당검사 방법별 지각된 통증정도에 대한 비교", 대한간호학회지, 제33권, 제7호, pp. 928-935, 2003.
  7. R. M. Cowett, & L. D'Amico, "Capillary (Heelstick) versus venous blood sampling for the determination of glucose concentration in the neonate", Biol Neonate, Vol. 62, pp. 32-36, 1992. https://doi.org/10.1159/000243850
  8. D. P. Barker, & N. Rutter, "Exposure to invasive procedures in neonatal intensive care unit admissions", Arch Dis Childhood, Vol. 72, pp. 48-49, 1995. https://doi.org/10.1136/adc.72.1.48
  9. N. McIntosh, L. van Veen, & H. Brameyer, "Alleviation of the pain of heel prick in preterm infants", Arch Dis Childhood, Vol. 70, pp. 177-181, 1994. https://doi.org/10.1136/fn.70.3.F177
  10. D. D. Cunningham, T. P. Henning, E. B. Shain, D. F. Young, T. A. Elstrom, E. J. Taylor, S. M. Schroder, P. M. Gatcomb, & W. V. Tamborlane, "Vacuum-assisted lancing of the forearm: an effective and less painful approach to blood glucose monitoring", Diabetes Techno. Ther, Vol. 2, pp. 541-548, 2000. https://doi.org/10.1089/15209150050501952
  11. 박미숙, 박경순, 김경아, 전명희, 김태임, 이태수, 차은종, "전완부위 최소통증 채혈을 위한 진공 자동 채혈기법", 대한의용생체공학회지, 제25권, 제6호, pp. 557-563, 2004.
  12. A. J. Brenneman, & D. G. Purcell, "Vacuum assisted lancing device" U.S. Patent No. 6,152,942, 2000.
  13. 김동균, 원종화, N. P. Sergey, V. M. Viacheslav, E. C. Evgenii, "밀리미터파를 이용한 무혈 혈당측정에 관한 기초연구", 전자공학회 논문지, 제42권, 제1호, pp. 3-6, 1998.
  14. R. W. Waynant & V. M. Chenault, "Overview of non-invasive fluid glucose measurement using techniques to maintain glucose control in diabetes millitus", LEOS newsletter, Vol. 12(2), pp. 3-6, 1998.
  15. J. G. Webster(Eds.), "Encyclopedia of medical devices and instrumentation" Vol. 3. Canada: Glucose sensors, John-Wiley & Sons Inc. 1988.
  16. E. K. Paul, S. W. Ruth, & B. N. John, Carbohydrates: In henry JB editors. "Clinical diagnosis and management by laboratory methods" pp. 214, WB Saunders, 2001.
  17. American Diabetes Association, "Consensus statement on self-monitoring of blood glucose", Diabetes Care, Vol. 10, pp. 95-99, 1987. https://doi.org/10.2337/diacare.10.1.95
  18. K. Jungheim & T. Koschinsky, "Glucose monitoring at the arm: Risky delays of hypoglycemia and hyperglycemia" Diabetes Care, Vol. 25(6), pp. 956-960, 2002. https://doi.org/10.2337/diacare.25.6.956
  19. K. Jungheim & T. Koschinsky, "Risky delays of hypoglycemia detection by Glucose monitoring at the arm", Diabetes Care, Vol. 24(7), pp. 1303-1304, July, 2001. https://doi.org/10.2337/diacare.24.7.1303
  20. American Diabetes Association, "Consensus statement on self-monitoring of blood glucose", Diabetes Care, Vol. 17, pp. 81-86, 1994. https://doi.org/10.2337/diacare.17.1.81

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