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Effects of hydroquinone-containing creams on capillary glycemia before and after serial hand washings in Africans

Article scientifique 2018 Anglais

Résumé

BACKGROUND: Hydroquinone-containing creams cause false increases in capillary glycemia. However, the magnitude of this false increase, and the means to reverse it have not been investigated. OBJECTIVE: To evaluate the technical and clinical impact of hydroquinone-containing creams on capillary glycemia and investigate the efficacy of hand washing and other common practices, in reversing cream effects. METHODS: We included 91 participants in a quasi-experimental study in Buea, Cameroon. After determining the hydroquinone content of a cream, Caro Light, we used two glucometers with different enzymatic systems (Accu-Chek Active and OneTouch Ultra 2) to measure fasting glycemia after: initial hand washing (reference), application of 1 ml of hydroquinone-containing cream, finger swabbing with wet gauze, sanitizer application and a series of three hand washings following cream application. Reference glycemia was compared to those obtained after various interventions. Statistical significance was assessed by paired sample t-test, clinical significance by total error allowable (TEa), and clinical impact by Parke's error grid analysis. RESULTS: The mean differences in capillary glycemia (Intervention-reference) measured by Accu-Chek Active in mg/dl were 28, 27, 38, 16, 4, and -2 after cream application, finger swabbing, sanitizer application, one, two, and three hand washings respectively. Corresponding values for OneTouch Ultra2 were 41, 44, 64, 22, 5 and -5. These differences, except after two and three hand washings were both statistically (p < 0.0001) and clinically significant (TEa). After cream application, Accu-Check had 9.9% of values in Parke's Zones C-E, while OneTouch had 18.7%. CONCLUSION: Hydroquinone-containing creams cause significant false increase in capillary glycemia irrespective of the enzymatic system of the glucometer used, and can lead to potentially wrong clinical decisions. A minimum of two hand washings is required prior to capillary glucose measurement.

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Choukem, S., Efie, D., Djiogue, S., Kaze, F., Mboue-Djieka, Y., Boudjeko, T., Dongo, É., Gautier, J., Kengne, A. (2018). Effects of hydroquinone-containing creams on capillary glycemia before and after serial hand washings in Africans. https://doi.org/10.1371/journal.pone.0202271

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Auteur(s)

Siméon Pierre Choukem Derrick Tembi Efie Séfirin Djiogue François Folefack Kaze Yannick Mboue-Djieka Thadée Boudjeko Étienne Dongo Jean–François Gautier André Pascal Kengne

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