Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus
| Autor: | Catherine Woods, Peter E. Hickman, Julia M. Potter, Carmen Oakman, Christopher J. Nolan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Blood Glucose Plasma Glucose Measurement Time Factors endocrine system diseases Endocrinology Diabetes and Metabolism Pre-Analytical Phase Physiology Centrifugation 030209 endocrinology & metabolism World health Specimen Handling Young Adult 03 medical and health sciences Endocrinology 0302 clinical medicine Pregnancy Diabetes mellitus Internal Medicine medicine Humans False Positive Reactions 030212 general & internal medicine Oral glucose tolerance Advanced and Specialized Nursing Sample handling Blood Specimen Collection Clinical Laboratory Techniques business.industry e-Letters: Observations Clinical Care/Education/Nutrition/Psychosocial Research Australia Australian capital nutritional and metabolic diseases Reproducibility of Results Fasting Glucose Tolerance Test medicine.disease Gestational diabetes Diabetes Gestational Female Guideline Adherence business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc20-0304 |
| Popis: | OBJECTIVE Preanalytical processing of blood samples can affect plasma glucose measurement because ongoing glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined. RESEARCH DESIGN AND METHODS All pregnant women in the Australian Capital Territory (ACT) are recommended for GDM testing with a 75-g OGTT using the World Health Organization diagnostic criteria. From January 2015 to May 2017, OGTT samples were collected into sodium fluoride (NaF) tubes and kept at room temperature until completion of the test (delayed centrifugation). From June 2017 to October 2018, OGTT samples in NaF tubes were centrifuged within 10 min (early centrifugation). RESULTS A total of 7,509 women were tested with the delayed centrifugation protocol and 4,808 with the early centrifugation protocol. The mean glucose concentrations for the fasting, 1-h, and 2-h OGTT samples were, respectively, 0.24 mmol/L (5.4%), 0.34 mmol/L (4.9%), and 0.16 mmol/L (2.3%) higher using the early centrifugation protocol (P < 0.0001 for all), increasing the GDM diagnosis rate from 11.6% (n = 869/7,509) to 20.6% (n = 1,007/4,887). CONCLUSIONS The findings of this study highlight the critical importance of the preanalytical processing protocol of OGTT blood samples used for diagnosing GDM. Delay in centrifuging of blood collected into NaF tubes will result in substantially lower rates of diagnosis than if blood is centrifuged early. |
| Databáze: | OpenAIRE |
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