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Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
Time is glucose, can't miss gestational diabetes
Roberto Festa1, Mariarosa Carta, Antonio Ceriello
1Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy. festa7r@libero.it
Diabetes Technology & Therapeutics
|February 25, 2012
Summary
Routine blood glucose testing for gestational diabetes mellitus (GDM) can lead to underdiagnosis due to pre-analytical variability. Adhering to laboratory guidelines is crucial for accurate GDM screening in early pregnancy.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Maternal-Fetal Medicine
Background:
- Gestational diabetes mellitus (GDM) screening is recommended for all or high-risk women during the initial prenatal visit.
- Diagnostic criteria for GDM involve fasting plasma glucose (FPG) levels between 92-126 mg/dL.
- Pre-analytical variability in glucose testing, including sample handling and storage, can impact diagnostic accuracy.
Observation:
- A study compared "routine" blood plasma glucose testing with a "gold standard" protocol in 60 pregnant women.
- "Routine" protocol involved delayed centrifugation (30-45 min post-collection) at room temperature.
- "Gold standard" protocol ensured centrifugation within 5 minutes of blood draw.
Findings:
- The "routine" protocol resulted in an average loss of 10 mg/dL glucose per determination.
- This variability led to the underdiagnosis of 13 GDM cases and 2 cases of overt diabetes in the preliminary series.
- Significant glucose degradation occurred in samples not promptly centrifuged.
Implications:
- There is a substantial risk of GDM underdiagnosis in the first half of pregnancy due to overlooked pre-analytical factors.
- Enhanced collaboration between clinicians and laboratory personnel is essential.
- Stricter adherence to established laboratory guidelines for blood sample processing is critical for accurate GDM diagnosis and management.
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