Pre-analytical Errors in Glucose Estimation Results in Query on Diabetic Management

Area of Science:

• Clinical Biochemistry
• Laboratory Medicine
• Analytical Chemistry

Background:

• Diabetes mellitus management requires frequent glucose monitoring.
• Current Indian laboratory practices often use serum or inappropriate plasma, risking in vitro glycolysis.
• This pre-analytical error can lead to inaccurate glucose estimations.

Purpose of the Study:

• To investigate pre-analytical variations in glucose estimation.
• To evaluate the efficacy of sodium fluoride-disodium EDTA (NaF-Na2EDTA) plasma in inhibiting glycolysis.
• To understand the mechanism of glycolysis inhibition by NaF-Na2EDTA.

Main Methods:

• Blood samples from 40 healthy volunteers (20-35 years) were collected.
• Pre-analytical variables studied included tube mixing (inversions), time from collection to centrifugation, and time from centrifugation to analysis.
• Comparative analysis of NaF-Na2EDTA plasma, EDTA plasma, and serum samples was performed.

Main Results:

• NaF-Na2EDTA plasma demonstrated complete inhibition of glycolysis, outperforming other collection methods.
• Other collection tubes showed significant increases in glycolysis.
• The evacuated blood collection system using NaF-Na2EDTA proved most effective against pre-analytical errors.

Conclusions:

• NaF-Na2EDTA plasma is a reliable method for preventing in vitro glycolysis in glucose estimations.
• Standardization and validation of glycolysis inhibitor tubes are crucial for accurate pre-analytical sample handling.
• Adoption of these tubes is recommended, especially in accredited laboratories.