Clinical impact of citrate-containing tubes on the detection of glucose abnormalities by the oral glucose tolerance test
-
Graziella Bonetti
,
Davide Giavarina
Abstract
Background
Plasma glucose levels provide the cornerstone of diabetes evaluation, and so it is crucial that clinical laboratories provide accurate and reliable plasma glucose results. To prevent in vitro glycolysis, citrate is used. Here, we present the first study on the 75-g oral glucose tolerance test (OGTT) using the currently available new citrate-containing tubes in liquid and granular forms and the previous sodium fluoride (NaF) for the diagnosis of carbohydrate metabolism disorders and gestational diabetes mellitus (GDM) according to the American Diabetes Association (ADA) guidelines.
Methods
The 75-g OGTT was performed in 147 volunteers, 83 of whom were pregnant women. Blood was collected in NaF/K3 ethylenediaminetetraacetic acid (EDTA) and NaF/Na2EDTA/citrate in liquid form in tubes in Brescia and in NaF/K2Ox and NaF/Na2EDTA/citrate in granular form in Vicenza. Glucose was measured within 3–4 h from the OGTT. The mean biases were calculated and compared with the desirable bias (<± 2.1%).
Results
OGTT glucose concentrations were higher in citrate tubes when compared to NaF-containing tubes. When citrate tubes were used, GDM increased to 12.5 and 11.7% in Brescia and Vicenza, respectively. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) increased to 36.7, 6.7 and 3.4%, respectively, in Brescia. In Vicenza, an increase of 47 and 1.9% in IFG and IGT, respectively, was found.
Conclusions
OGTT glucose measurement in citrate-containing tubes was shown to be more effective than those containing only NaF in diagnosing carbohydrate disorders. This new glycolysis inhibitor seems to be a necessary preanalytical tool for accurate and reliable plasma glucose results.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) 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.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Competencies for improving diagnosis: an important developmental step forward
- Guidelines and Recommendations
- Recommendations for using the Revised Safer Dx Instrument to help measure and improve diagnostic safety
- Review
- What interventions could reduce diagnostic error in emergency departments? A review of evidence, practice and consumer perspectives
- Original Articles
- Competencies for improving diagnosis: an interprofessional framework for education and training in health care
- Primary adrenal insufficiency in the United States: diagnostic error and patient satisfaction with treatment
- Follow-up of incidental pulmonary nodules and association with mortality in a safety-net cohort
- Assessing diagnostic error in cerebral venous thrombosis via detailed chart review
- Can citrate plasma be used in exceptional circumstances for some clinical chemistry and immunochemistry tests?
- Clinical impact of citrate-containing tubes on the detection of glucose abnormalities by the oral glucose tolerance test
- Letter to the Editor
- Public perception of diagnostic and laboratory errors among Internet users
- Case Report – Lessons in Clinical Reasoning
- Lessons in clinical reasoning – pitfalls, myths, and pearls: a case of chest pain and shortness of breath
- Case Report
- Kimura disease: a case report of a rare illness presenting as a common complaint
- Acknowledgment
- Congress Abstracts
- The Diagnostic Error in Medicine 12th Annual International Conference
Articles in the same Issue
- Frontmatter
- Editorial
- Competencies for improving diagnosis: an important developmental step forward
- Guidelines and Recommendations
- Recommendations for using the Revised Safer Dx Instrument to help measure and improve diagnostic safety
- Review
- What interventions could reduce diagnostic error in emergency departments? A review of evidence, practice and consumer perspectives
- Original Articles
- Competencies for improving diagnosis: an interprofessional framework for education and training in health care
- Primary adrenal insufficiency in the United States: diagnostic error and patient satisfaction with treatment
- Follow-up of incidental pulmonary nodules and association with mortality in a safety-net cohort
- Assessing diagnostic error in cerebral venous thrombosis via detailed chart review
- Can citrate plasma be used in exceptional circumstances for some clinical chemistry and immunochemistry tests?
- Clinical impact of citrate-containing tubes on the detection of glucose abnormalities by the oral glucose tolerance test
- Letter to the Editor
- Public perception of diagnostic and laboratory errors among Internet users
- Case Report – Lessons in Clinical Reasoning
- Lessons in clinical reasoning – pitfalls, myths, and pearls: a case of chest pain and shortness of breath
- Case Report
- Kimura disease: a case report of a rare illness presenting as a common complaint
- Acknowledgment
- Congress Abstracts
- The Diagnostic Error in Medicine 12th Annual International Conference
