Journal Article
. 2017 Jul; 11(3):577-583.
doi: 10.1177/1932296816678428.

Impact of Xylose on Glucose-Dehydrogenase-Based Blood Glucose Meters for Patient Self-Testing

Andreas Pfützner 1 Filiz Demircik 1 Daniela Sachsenheimer 1 Jan Spatz 2 Anke H Pfützner 2 Sanja Ramljak 2 
  • PMID: 28745092
  •     22 References
  •     1 citations


The pentose xylose is enriched in edible algae, and is increasingly used as a slowly metabolized carbohydrate in functional food. It is known to interfere with glucose-dehydrogenase-based (GDH) blood glucose measurement systems for patients self-testing. The aim of our study was to investigate the extent of xylose interference in commercially available blood glucose meters. A heparinized whole blood sample was manipulated to contain 3 different glucose concentrations (50-80 mg/dL, 130-160 mg/dL, and 250-300 mg/dL) and 4 different xylose concentrations (0 mg/dL, 25 mg/dL, 50 mg/dL, and 100 mg/dL). Each sample was measured 3 times with 2 different strip lots per test meter (AccuChek Aviva, AccuChek Connect, Contour Next, FreeStyle Freedom Lite, FreeStyle Insulinx, MyStar Extra, OneTouch Verio IQ, and Wellion Calla, reference: YSI GlucoStat analyzer). For analysis, we calculated the xylose capture rate, that is, the xylose amount wrongly displayed as glucose. No xylose interference was seen with 4 meters: AccuChek Aviva (mean capture rate 0%), AccuChek Connect (-2%), MyStar Extra (10%), and Wellion Calla (8%). In contrast, substantial interference was observed with Contour Next (100%), FreeStyle Freedom Lite (104%), FreeStyle Insulinx (120%), and OneTouch Verio IQ (162%). We observed xylose interference in several GDH-based meters. This may become important with increased use of xylose in dietary and functional food products, in particular in products designed for weight loss. Our findings may affect the meter selection for patients who are consuming such food products as part of their lifestyle treatment regimen.

Keywords: blood glucose measurement; glucose dehydrogenase; test strips; xylose interference.

D-Xylose as a sugar complement regulates blood glucose levels by suppressing phosphoenolpyruvate carboxylase (PEPCK) in streptozotocin-nicotinamide-induced diabetic rats and by enhancing glucose uptake in vitro.
Eunju Kim, Yoo-Sun Kim, +3 authors, Yuri Kim.
Nutr Res Pract, 2016 Feb 13; 10(1). PMID: 26865911    Free PMC article.
D-xylose testing.
R M Craig, E D Ehrenpreis.
J Clin Gastroenterol, 1999 Sep 09; 29(2). PMID: 10478874
Structural characterization and immunomodulatory activity of a new heteropolysaccharide from Prunella vulgaris.
Chao Li, Lijun You, +3 authors, Rui Hai Liu.
Food Funct, 2015 Apr 01; 6(5). PMID: 25825862
Optimised formation of blue Maillard reaction products of xylose and glycine model systems and associated antioxidant activity.
Zi Yin, Qian Sun, Xi Zhang, Hao Jing.
J Sci Food Agric, 2013 Nov 01; 94(7). PMID: 24173610
Bioactive Plant Metabolites in the Management of Non-Communicable Metabolic Diseases: Looking at Opportunities beyond the Horizon.
Chandan Prasad, Victorine Imrhan, +4 authors, Parakat Vijayagopal.
Metabolites, 2015 Dec 26; 5(4). PMID: 26703752    Free PMC article.
Characterization, antioxidant and antitumor activities of polysaccharides from purple sweet potato.
Qiongying Wu, Hongsen Qu, +4 authors, Zhongzheng Gui.
Carbohydr Polym, 2015 Aug 11; 132. PMID: 26256321
One-hour blood xylose in the diagnosis of cows milk protein-sensitive enteropathy.
N Iyngkaran, Z Abidin.
Arch Dis Child, 1982 Jan 01; 57(1). PMID: 7065692    Free PMC article.
Utilization of nutrients in milk- and wheat-based diets by men with adequate and reduced abilities to absorb lactose. I. Energy and nitrogen.
D H Calloway, W L Chenoweth.
Am J Clin Nutr, 1973 Sep 01; 26(9). PMID: 4740859
One-hour serum xylose as an absorption test in the tropics.
P G Hill, I N Ross, +2 authors, V I Mathan.
J Clin Pathol, 1981 Feb 01; 34(2). PMID: 7229097    Free PMC article.
The Burkholderia contaminans MS14 ocfC gene encodes a xylosyltransferase for production of the antifungal occidiofungin.
Kuan-Chih Chen, Akshaya Ravichandran, +4 authors, Shi-En Lu.
Appl Environ Microbiol, 2013 Feb 26; 79(9). PMID: 23435879    Free PMC article.
Glucagon-like peptide 1 (7-36 amide) secretion in response to luminal sucrose from the upper and lower gut. A study using alpha-glucosidase inhibition (acarbose).
C Qualmann, M A Nauck, +2 authors, W Creutzfeldt.
Scand J Gastroenterol, 1995 Sep 01; 30(9). PMID: 8578189
A new test strip technology platform for self-monitoring of blood glucose.
Robert Bernstein, Joan Lee Parkes, +7 authors, Timothy S Bailey.
J Diabetes Sci Technol, 2013 Oct 16; 7(5). PMID: 24124968    Free PMC article.
Physicochemical and Functional Properties of Insoluble Dietary Fiber Isolated from Bambara Groundnut (Vigna subterranea [L.] Verdc.).
Claudine F Diedericks, Victoria A Jideani.
J Food Sci, 2015 Aug 11; 80(9). PMID: 26256094
Standardised approach to gluten challenge in diagnosing childhood coeliac disease.
C J Rolles, A S McNeish.
Br Med J, 1976 May 29; 1(6021). PMID: 1268678    Free PMC article.
Intestinal absorption of D-xylose in man.
N Engl J Med, 1962 Aug 09; 267. PMID: 13894031
Small intestinal malabsorption in chronic alcoholism: a retrospective study of alcoholic patients by the ¹⁴C-D-xylose breath test.
Håvar Hope, Viggo Skar, +2 authors, Asle W Medhus.
Scand J Gastroenterol, 2012 Jan 11; 47(4). PMID: 22229732
Sensory characteristics and consumer acceptability of beef stock containing the glutathione-xylose Maillard reaction product and/or monosodium glutamate.
Jae-Hee Hong, Koo-Young Kwon, Kwang-Ok Kim.
J Food Sci, 2012 May 18; 77(6). PMID: 22591448
A novel polysaccharide from Lentinus edodes Mycelia exhibits potential antitumor activity on laryngeal squamous cancer cell line Hep-2.
Xiangyu Cao, Ruihua Liu, +4 authors, Chao Yang.
Appl Biochem Biotechnol, 2013 Aug 21; 171(6). PMID: 23955351
A comprehensive evaluation of strip performance in multiple blood glucose monitoring systems.
Laurence B Katz, Kirsty Macleod, +3 authors, Steven Setford.
Expert Rev Med Devices, 2015 Feb 24; 12(3). PMID: 25702769
Coconut-derived D-xylose affects postprandial glucose and insulin responses in healthy individuals.
Yun Jung Bae, Youn-Kyung Bak, +3 authors, Mi-Kyung Sung.
Nutr Res Pract, 2012 Jan 20; 5(6). PMID: 22259678    Free PMC article.
O M Helmer, P J Fouts.
J Clin Invest, 1937 May 01; 16(3). PMID: 16694483    Free PMC article.
Comparative effects of glucose and xylose on blood pressure, gastric emptying and incretin hormones in healthy older subjects.
Lora Vanis, Trygve Hausken, +5 authors, Karen L Jones.
Br J Nutr, 2011 Feb 08; 105(11). PMID: 21294929
Interference Assessment of Various Endogenous and Exogenous Substances on the Performance of the Eversense Long-Term Implantable Continuous Glucose Monitoring System.
Carrie Lorenz, Wendolyn Sandoval, Mark Mortellaro.
Diabetes Technol Ther, 2018 Mar 31; 20(5). PMID: 29600877    Free PMC article.