Pregnancy diabetes: A comparison of diagnostic protocols based on point-of-care, routine and optimized laboratory conditions

• Published in: Scientific reports 2015-11, Vol.5 (1), p.16302-16302, Article 16302
• Main Authors: van den Berg, Sjoerd A. A., de Groot, Monique J. M., Salden, Lorenzo P. W., Draad, Patrick J. G. J., Dijkstra, Ineke M., Lunshof, Simone, van Thiel, Sjoerd W., Boonen, Kristel J. M., Thelen, Marc H. M.
• Format: Article
• Language: English
• Subjects: 49/47; 49/56; 631/45/776; 692/163/2743/137/1926; 82/56; Blood Glucose - analysis; Diabetes; Diabetes mellitus; Diabetes, Gestational - diagnosis; Female; Glucose; Glucose tolerance; Glucose Tolerance Test; Glycolysis; Heparin; Humanities and Social Sciences; Humans; Laboratories; multidisciplinary; Point-of-Care Systems; Pregnancy; Protocol; Science; Sensitivity and Specificity
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep16302

In vitro glycolysis poses a problem during diabetes screening, especially in remote laboratories. Point-of-care analysis (POC) may provide an alternative. We compared POC, routine and STAT analysis and a feasible protocol during glucose tolerance test (GTT) for pregnancy diabetes (GDM) screening. In the routine protocol, heparin tubes were used and turn-around-time (TAT) was unsupervised. In the STAT protocol, tubes were processed immediately. The feasible protocol comprised of citrated tubes with a TAT of 1 hour. Outcome was defined as glucose concentration and clinical diagnosis. Glucose measured by POC was higher compared to routine analysis at t = 0 (0.25 mM) and t = 120 (1.17 mM) resulting in 17% more GDM diagnoses. Compared to STAT analysis, POC glucose was also higher, although less pronounced (0.06 and 0.9 mM at t = 0 and t = 120 minutes, respectively) and misclassification was only 2%. Glucose levels and clinical diagnosis were similar using the feasible protocol and STAT analysis (0.03 mM and −0.07 mM at t = 0 and t = 120, 100% identical diagnoses). POC is an viable alternative for STAT glucose analysis in GDM screening (sensitivity: 100%, specificity: 98%). A feasible protocol (citrated phlebotomy tubes with a TAT of 60 minutes) resulted in 100% identical outcome and provides the best alternative.