Diagnosis of Gestational Diabetes Mellitus Will Be Flawed until We Can Measure Glucose

Glucose is lost from whole blood samples at a rate of 5%-7% per hour at room temperature (8). [...]loss of glucose at 1 h exceeds the desirable limit of total analytical error for glucose based on biological variation. [...]variation in time to centrifugation of blood samples introduces variability...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 2020-02, Vol.66 (2), p.265-267
Main Authors: Bruns, David E, Metzger, Boyd E, Sacks, David B
Format: Article
Language:English
Subjects:
Accuracy
Blood
Blood Glucose
Centrifugation
Dextrose
Diabetes
Diabetes in pregnancy
Diabetes mellitus
Diabetes, Gestational
Diagnosis
Diagnostic systems
Error analysis
Ethylenediaminetetraacetic acid
Female
Fluorides
Gestational diabetes
Glucose
Glucose Tolerance Test
Hemoglobin
Humans
Hyperglycemia
Laboratories
Likelihood ratio
Measurement
Measuring instruments
Point-of-Care Systems
Pregnancy
Prospective Studies
Room temperature
Variability
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Summary:Glucose is lost from whole blood samples at a rate of 5%-7% per hour at room temperature (8). [...]loss of glucose at 1 h exceeds the desirable limit of total analytical error for glucose based on biological variation. [...]variation in time to centrifugation of blood samples introduces variability in glucose results with resultant variability in likelihood of diagnosis of GDM. [...]these authors have evaluated the potential of glucose meters, used at the point of care, to improve the diagnostic accuracy of testing for GDM by minimizing the loss of glucose before analysis (12). [...]they measured glucose in skin-puncture blood at the POC, with samples collected from patients in the fasting state and at 1 and 2 h after a 75-gram oral glucose load. Using a specificity of 95% (rather than 100%), the positive likelihood ratio is >17. [...]a positive result connotes a large, >45%, increase in post-test probability of GDM.
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/hvz027