Abstract:
Background: Gestational diabetes is a pathological condition that threatens the maternal and fetal health. The prevalence depends on the population studied and the laboratory tests, as there is no national or international consensus on this point. Venous blood plasma glucose assay is required for diagnosis in all cases. EDTA-fluoride do not inhibit anaerobic glycolysis during the first two hours post blood-withdrawal and citrate-fluoride is a more efficient glycolysis inhibitor. This provides a new source of pre-analytical variability in the diagnosis.
Objectives: a) compare the results obtained with different plasma glucose inhibitors (Heparin in ice- water bath, EDTA-FLUORIDE and CITRATE-FLUORIDE) processed immediately and after 2 hours incubation; b) assess whether the use of EDTA-FLUORIDE or CITRATE-FLUORIDE modifies gestational diabetes diagnosis.
Materials & Methods: 190 non pregnant adult samples were collected to reach objective "a"; and 312 samples from 52 pregnant patients to assess the Gestational Diabetes diagnosis following the IADPSG protocol.
Results: results showed that EDTA-FLUORIDE do not inhibit glycolysis efficiently during the evaluated time. CITRATE-FLUORIDE achieved a superior glycolysis inhibition, compared to Heparin in ice-water bath (gold standard). CITRATE-FLUORIDE inhibitor showed a higher sensitivity for the diagnosis of Gestational Diabetes.
Conclusion: Therefore, it is essential to standardize the pre-analytical phase and the cut-off values for this Inhibitor-anticoagulant.