Now showing 1 - 3 of 3
  • Publication
    A national survey of preanalytical handling of oral glucose tolerance tests in pregnancy
    While the criteria for the diagnosis of gestational diabetes mellitus (GDM) continue to be mired in controversy with a lack of international consensus, many countries and the World Health Organization have adopted the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations. In addtion, revised stricter recommendations have also been produced and endorsed by the National Academy of Clinical Biochemistry (NACB) for laboratory standards in the analysis of maternal glucose measurements.
      306Scopus© Citations 10
  • Publication
    Impact of Implementing Preanalytical Laboratory Standards on the Diagnosis of Gestational Diabetes Mellitus: A Prospective Observational Study
    (American Association for Clinical Chemistry, 2016-02) ; ; ; ; ;
    Background: Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes, but risk is reduced with identification and early treatment. Glucose measurements are affected by preanalytical sample handling, such as temperature of storage, phlebotomy–analysis interval, and use of a glycolysis inhibitor. We evaluated glucose concentrations and the incidence of GDM after strict implementation of the American Diabetes Association (ADA) preanalytical guidelines, compared with usual hospital conditions. Methods: Women screened selectively for GDM at 24 –32 weeks’ gestation were recruited at their convenience before a 75-g oral glucose tolerance test. Paired samples were taken: the first sample followed ADA recommendations and was transferred to the laboratory on an iced slurry for immediate separation and analysis (research conditions), and the second sample was not placed on ice and was transferred according to hospital practice (usual conditions). Results: Of samples from 155 women, the mean fasting, 1-h, and 2-h results were 90.0 (12.6) mg/dL [5.0 (0.7) mmol/L], 142.2 (43.2) mg/dL [7.9 (2.4) mmol/L], and 102.6 (32.4) mg/dL [5.7 (1.8) mmol/L], respectively, under research conditions, and 81 (12.6) mg/dL [4.5 (0.7) mmol/L], 133.2 (41.4) mg/dL [7.4 (2.3) mmol/L], and 99 (32.4) mg/dL [5.5 (1.8) mmol/L] under usual conditions (all P 0.0001). GDM was diagnosed in 38.1% (n 59) under research conditions and 14.2% (n 22) under usual conditions (P 0.0001). The phlebotomy–analysis interval for the fasting, 1-h, and 2-h samples was 20 (9), 17 (10), and 17 (9) min under research conditions and 162 (19), 95 (23), and 32 (19) min under usual conditions (all P 0.0001). All cases of GDM were diagnosed on fasting or 1-h samples; the 2-h test diagnosed no additional cases. Conclusions: Implementation of ADA preanalytical glucose sample handling recommendations resulted in higher mean glucose concentrations and 2.7-fold increased detection of GDM compared with usual hospital practices.
      324Scopus© Citations 39
  • Publication
    Comparison of citrate-fluoride-EDTA with fluoride-EDTA additives to stabilize plasma glucose measurements in women being screened during pregnancy with an oral glucose tolerance test: a prospective observational study
    (The American Association for Clinical Chemistry, 2016-06) ; ; ; ; ;
    We recently highlighted the importance of implementing recommended preanalytical standards to avoid missing the diagnosis of gestational diabetes mellitus (GDM)1(1 ).The placement of samples on an ice slurry with separation within 30 min, however, is not always practical.
      264Scopus© Citations 14