Plasma glucose measurement in diabetes: impact and implications of variations in sample collection procedures with a focus on the first hour after sample collection
-
Huan Chan
,
Harmony Thompson
Abstract
Background: Previous studies of participants with plasma glucose concentrations at or near the glucose reference range demonstrate glucose loss following delayed separation and extraction of plasma from the cellular components of blood, of ≤7% per hour. We aimed to assess pre-analytical glucose loss in diabetic subjects, focusing on the first hour after sample collection.
Methods: Venous blood was collected from diabetes clinic attendees, into a series of lithium heparin PST™ (plasma separator tube) and fluoride oxalate Vacutainers™. Baseline (reference) plasma glucose measurements were undertaken on samples prepared under refrigerated conditions. The remaining samples underwent a series of controlled pre-analytical delays in sample preparation, at room temperature. Plasma glucose was measured using the hexokinase method.
Results: Median baseline glucose (mmol/L) for the 62 participants was 10.6 (range 3.4–31.1). Using lithium heparin PST™ tubes, mean glucose loss (95% CI) was 0.16 (0.09–0.23) after 30 min delay in plasma preparation and 0.28 (0.21–0.34) after 60 min delay. Glucose loss was independent of both baseline glucose and also individual cellular count. Fluoride failed to inhibit glucose loss within the first hour after sample collection. Immediate plasma centrifugation of PST™ tubes, followed by delayed plasma extraction (median delay 92 min), produced a mean glucose loss of 0.02 mmol/L (–0.05–0.09).
Conclusions: Samples collected into lithium heparin PST™ tubes show pre-analytical glucose loss at 1 h that is independent of baseline glucose and cellular count. Furthermore, immediate plasma separation using these tubes attenuates glucose loss across a wide range of glucose concentrations.
Acknowledgments
We thank Florence Logan for her expert technical assistance with sample collection and Dr. Brett Shand for his comments on study design. HT was supported by a University of Otago, Christchurch Summer Studentship.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research support played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Author contribution: HC co-wrote the manuscript and conducted the statistical analyses. HL led the write-up of the manuscript and had primary responsibility for study design and final content. HL is also the guarantor of this study. HT contributed to study design, collected samples and contributed to preparation of Figures. HFH contributed to study design and sample collection and edited the manuscript. CMF advised on laboratory aspects and co-wrote the manuscript. CMAF oversaw statistical analysis and edited the manuscript.
Ethical statement: The study had Health and Disability Ethics Committee (New Zealand) approval; HDEC number 12/STH/22/AM01.
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©2014 by Walter de Gruyter Berlin/Boston
Artikel in diesem Heft
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- Diagnosis of diabetes mellitus: reiterated responsibilities for the clinical laboratory
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- Sigma metrics used to assess analytical quality of clinical chemistry assays: importance of the allowable total error (TEa) target
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- Plasma glucose measurement in diabetes: impact and implications of variations in sample collection procedures with a focus on the first hour after sample collection
- Changing from glucose to HbA1c for diabetes diagnosis: predictive values of one test and importance of analytical bias and imprecision
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- Letter to the Editors
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Diagnosis of diabetes mellitus: reiterated responsibilities for the clinical laboratory
- Review
- The association between plasminogen activator inhibitor type 1 (PAI-1) levels, PAI-1 4G/5G polymorphism, and myocardial infarction: a Mendelian randomization meta-analysis
- Opinion Papers
- Harmonization of quality indicators in laboratory medicine. A preliminary consensus
- Cardiac biomarkers and risk assessment in patients undergoing major non-cardiac surgery: time to revise the guidelines?
- General Clinical Chemistry and Laboratory Medicine
- A statistical basis for harmonization of thyroid stimulating hormone immunoassays using a robust factor analysis model
- Sigma metrics used to assess analytical quality of clinical chemistry assays: importance of the allowable total error (TEa) target
- Combined light chain immunofixation to detect monoclonal gammopathy: a comparison to standard electrophoresis in serum and urine
- Automated indirect immunofluorescence microscopy enables the implementation of a quantitative internal quality control system for anti-nuclear antibody (ANA) analysis
- Peripheral blood lymphocytes from patients with bipolar disorder demonstrate apoptosis and differential regulation of advanced glycation end products and S100B
- Coefficient of energy balance, a new parameter for basic investigation of the cerebrospinal fluid
- Interconversion of stone composition profiles from two recurrent stone episodes in stone formers
- Reference Values
- Complete blood count reference intervals and age- and sex-related trends of North China Han population
- Cancer Diagnostics
- The quantification of HER2 and MYC gene fragments in cell-free plasma as putative biomarkers for gastric cancer diagnosis
- Cardiovascular Diseases
- Novel sensitive cardiac troponin I immunoassay free from troponin I-specific autoantibody interference
- Interleukin-6 receptor Asp358Ala gene polymorphism is associated with plasma C-reactive protein levels and severity of aortic valve stenosis
- Diabetes
- Stability of glucose in plasma with different anticoagulants
- Plasma glucose measurement in diabetes: impact and implications of variations in sample collection procedures with a focus on the first hour after sample collection
- Changing from glucose to HbA1c for diabetes diagnosis: predictive values of one test and importance of analytical bias and imprecision
- System accuracy evaluation of systems for point-of-care testing of blood glucose: a comparison of a patient-use system with six professional-use systems
- Letter to the Editors
- Reply to the article entitled “Identification of an 18 bp deletion in the TWIST1 gene by CO-amplification at lower denaturation temperature-PCR (COLD-PCR) for non-invasive prenatal diagnosis of craniosynostosis: first case report” by Galbiati et al., Clin Chem Lab Med 2014;52(4):505–9
- Further considerations concerning non-invasive prenatal diagnosis of craniosynostosis based on the identification of an 18 bp deletion in the TWIST1 gene by COLD-PCR
- Sensible use of laboratory testing requires active laboratory involvement
- Digoxin overdose – an accurate method for determining free digoxin concentrations on general chemistry analysers post DigiFab treatment
- Method-specific differences in β-isomerised carboxy-terminal cross-linking telopeptide of type I collagen and procollagen type I amino-terminal propeptide using two fully automated immunoassays
- Evaluation of mutation profiling by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry in fine needle aspirations from papillary thyroid cancer
- Evaluation of Calfast® immunochromatographic quantitative assay for the measurement of calprotectin in faeces
- Measurement error in estimated average glucose: a novel approach
- Feasibility of an EQAS for HbA1c in Italy using fresh blood samples
- Congress Abstracts
- 5th Annual International Symposium on Kallikreins and Kallikrein-Related Peptidases
