Diagnostic significance of different plasma glucose analytical techniques in the clinical daily routine concerning the diagnostics of gestation diabetes

• Published in: Experimental and Clinical Endocrinology & Diabetes
• Main Authors: Klein, F, Groten, T, Schleußner, E, Wolf, G, Hunger-Battefeld, W
• Format: Conference Proceeding
• Language: English
• Published: 07.03.2013
• DOI: 10.1055/s-0033-1336781
• ISSN: 0947-7349

Introduction: Since 2012 plasma glucose analyses in the diagnostics of gestation diabetes (GDM) has exclusively allowed the use of venous blood instead of capillary blood. Objective: The question now is whether the change in this diagnostic standard influences relevant results. Methods: To find a feasible solution, we simultaneously used 5 different oGTT analysis techniques in 90 pregnant women. Everytime plasma was used. The analysis techniques used included: venous blood in an NaF-monovette (ivL), venous blood in Hemocue (ivH) and SuperGL easy+(ivS), capillary blood in Hemocue (kH) and SuperGL easy+(cS). GDM was diagnosed if the SuperGL easy+ showed at least one pathological value. Results: There are significant differences in all analytical techniques. However, the prevalence for GDM using Hemocue and Super GL easy+ with venous or capillary blood showed no significant difference. But using the NaF system GDM was diagnosed significantly less frequently. ivL: 4.7 ± 0.7/9.0 ± 2.0/6.7 ± 1.8; GDM 24% ivH: 5.0 ± 0.8/8.4 ± 2.1/7 ± 0.7; GDM 52% kH: 5.2 ± 0.7/8.9 ± 2.0/7.4 ± 1.7; GDM 57% kS: 4.9 ± 0.7/9.0 ± 2.0/7.1 ± 1.8; GDM 43% ivS: 4.8 ± 0.6/8.7 ± 2.0/7 ± 1.8; GDM 45.7% p < 0.05 all vs. NaF, p < 0.05 capillary vs. i.v. 76% of the participants who were not diagnosed with GDM using the NaF technique developed a condition liable to obligatory therapy. Using sodium fluoride a chemical stabilisation of glucose is achieved too late. Therefore the results are too low which leads to diagnostic errors. Sarstedt AG has now introduced a new system using liquid citrate buffer which is currently used for comparison measurements. Those results could not be included in this analysis. Conclusion: Considering the low reproducibility of the oGTT clinical markers including maternal risk factors and fetal parameters have to be taken into account. A less invasive analysis technique using capillary blood is if clinical parameters are also considered a valid method for diagnosing GDM.