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Stabilization of Glucose in Blood Samples: Why It Matters

¹ Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA; ² Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ.

^aAddress correspondence to this author at: Department of Pathology, P.O. Box 800168, University of Virginia School of Medicine, Charlottesville, VA 22908. Fax 1-434-924-2574; e-mail dbruns@virginia.edu.

The first 20% of the full text of this article appears below.

In this issue of Clinical Chemistry, Gambino et al. (1) describe careful studies of a blood-collection container that stabilizes the concentration of glucose in blood samples. At a time of an increasing disease burden attributable to diabetes and the use of lower glucose concentrations than in the past for the diagnosis of diabetes, this study and its findings are especially important.

Measurements of glucose are used worldwide to diagnose diabetes and to identify patients at risk of developing diabetes [e.g., (2)(3)]. For both diagnosis and risk assessment, fixed cutpoints of plasma glucose concentrations are used to classify patients and to make decisions regarding management. For this reason, all steps in the analytical process require careful attention.

Sources of Error in Measurements of Plasma Glucose

Clinical chemists in hospital laboratories and diagnostic companies have made great strides in improving the measurement of glucose. With the use of enzymatic methods and sophisticated analyzers with stable optics, electronics, fluid handling, and other components, central clinical laboratories routinely achieve an astoundingly low within-laboratory imprecision (CV) of 1%–2%. [Glucose meters do not fare so well and are not recommended for diagnosis of diabetes (4).] By contrast, the preanalytical issues surrounding glucose measurements have not been solved.

The loss of glucose in blood samples has been studied for many years (5). Glucose is lost through glycolysis at a rate of 5%–7%/h at concentrations near the reference interval. In absolute terms, a loss in glucose of about 0.67 mmol/L (12 mg/dL) occurs at a concentration of 5.55 mmol/L (100 mg/dL) after 2 h at room temperature (6). Higher rates of loss occur commonly, such as with increased ambient temperature and in samples with high white blood cell counts. . . . [Full Text of this Article]

Diagnosis of Diabetes

Further Implications of a Truly Stabilized Glucose Sample

The following articles in journals at HighWire Press have cited this article:

				The International Expert Committee International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes Diabetes Care, July 1, 2009; 32(7): 1327 - 1334. [Full Text] [PDF]