There also seems to be a third component to the risk: hospitalization. Apparently, some hospitals and other healthcare facilities are using GDH-PQQ glucose test strips. The FDA suggests using only laboratory-based glucose assays on patients receiving such products. It's my surmise (although not stated in the FDA's discussion) that some patients using these products may be on other types of BG strips at home, and having no problem. But if they were hospitalized somewhere that routinely uses GDH-PQQ glucose test strips, the problem would suddenly develop.

Thus, it would require a combination of three things to cause the problem: use of a GDH-PQQ BG strip, use of a product containing maltose, galactose or xylose, and hospitalization.

This interaction does bring back to mind one of my favorite aphorisms about diabetes: there are a hundred things that influence blood glucose levels, and we physicians know about 50 of them. Or now, let's make it 51.