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Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus.
Potter, Julia M; Hickman, Peter E; Oakman, Carmen; Woods, Catherine; Nolan, Christopher J.
Afiliación
  • Potter JM; Australian National University Medical School, Australian National University, Acton, Australian Capital Territory, Australia.
  • Hickman PE; Department of Chemical Pathology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
  • Oakman C; Australian National University Medical School, Australian National University, Acton, Australian Capital Territory, Australia.
  • Woods C; Department of Chemical Pathology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
  • Nolan CJ; Department of Chemical Pathology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
Diabetes Care ; 43(7): 1438-1441, 2020 07.
Article en En | MEDLINE | ID: mdl-32350020
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glucemia / Recolección de Muestras de Sangre / Diabetes Gestacional / Adhesión a Directriz / Fase Preanalítica Tipo de estudio: Diagnostic_studies / Evaluation_studies / Guideline Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Oceania Idioma: En Revista: Diabetes Care Año: 2020 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glucemia / Recolección de Muestras de Sangre / Diabetes Gestacional / Adhesión a Directriz / Fase Preanalítica Tipo de estudio: Diagnostic_studies / Evaluation_studies / Guideline Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Oceania Idioma: En Revista: Diabetes Care Año: 2020 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos