Maltose, Galactose, and Xylose May Yield Falsely Elevated Glucose Readings

The U.S. Food and Drug Administration (FDA) has notified healthcare professionals regarding the potential for falsely elevated glucose readings in patients tested using glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ)–glucose monitoring systems after receiving other sugars.

Because the GDH-PQQ method is not glucose-specific, readings may be falsely increased in patients receiving oral d-xylose or parenteral drug products containing maltose or galactose, according to an alert sent today from MedWatch, the FDA’s safety information and adverse event reporting system.

Although this is a known drug-device interaction, the FDA has received reports of fatal and life-threatening hypoglycemia due to inappropriate insulin administration in patients with erroneously high glucose readings obtained while using maltose-containing parenteral products.

In addition, such readings may mask cases of potentially life-threatening true hypoglycemia.

Patients receiving products containing maltose (or sugars that are metabolized to maltose such as icodextrin), galactose, or xylose should be tested using glucose dehydrogenase nicotine–adenine dinucleotide (GDH-NAD), glucose oxidase– or glucose hexokinase–based tests.

A preliminary list of products that may interfere with GDH-PQQ–based glucose meters is available at https://www.fda.gov/cber/safety/maltose110405.htm. Healthcare professionals who prescribe a GDH-PQQ–based method for routine outpatient glucose monitoring are advised to notify affected patients regarding the need for glucose-specific testing.

https://www.fda.gov/medwatch