Spurious Elevation of Glucose Concentration during Administration of High Dose of Ascorbic Acid in a Patient with Type 2 Diabetes on Hemodialysis

• Published in: Yonsei medical journal Vol. 54; no. 5; pp. 1289 - 1292
• Main Authors: Kim, Soo Kyoung, Hahm, Jong Ryeal, Kim, Ho-Su, Kim, Sungsu, Jung, Tae Sik, Jung, Jung Hwa, Lee, Hye Ryun, Kim, Deok Ryong
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.09.2013; 연세대학교의과대학
• Subjects: Adult; Ascorbic Acid - administration & dosage; Ascorbic Acid - adverse effects; Ascorbic Acid - therapeutic use; Blood Glucose; Blood Glucose Self-Monitoring - instrumentation; Blood Glucose Self-Monitoring - standards; Case Report; Contraindications; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Female; Humans; Hypoglycemia - diagnosis; Renal Dialysis; 의학일반; ascorbic acid; Self-monitoring of blood glucose; hypoglycemia
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2013.54.5.1289

We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.