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Pre-analytical Errors in Glucose Estimation Results in Query on Diabetic Management

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Abstract

Status of diabetes of an individual is majorly evaluated by the frequent monitoring of glucose estimation. Use of serum samples and inappropriate plasma for estimating glucose is an existing practise in Indian standard of laboratories. There is a strong evidence for occurrence of in vitro glycolysis on the above mentioned specimens. The aim is to study the pre-analytical variations on the glucose estimation of using sodium fluoride–disodium EDTA (NaF–Na2EDTA) plasma (glycolysis inhibiting anticoagulant) and determine the fact behind the activity of glycolysis inhibition on the same. Healthy volunteers 20–35 years of both genders consisting of 40 members were selected for the study, and after getting the informed consent form, random blood samples were collected to study the errors of pre-analytical i.e., mixing of NaF–Na2EDTA tube by phlebotomist (no of inversion). Difference in duration from blood collection to centrifugation and a variable in time were taken from centrifugation to analyzing the plasma sample. Comparative studies on EDTA plasma and serum sample were also carried out. The usage of the evacuated blood collection system on NaF–Na2EDTA was shown to have the complete glycolysis inhibitor among all pre-analytical errors, whereas other tubes shown considerable increase in glycolysis. Recently the use of glycolysis inhibitor tubes are come into practise only in accredited or certified laboratories. Hence the authentication of glycolysis inhibition study is mandatory for the pre-analytical variations on the same.

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Acknowledgements

The authors like to thank—Tamil Nadu State Council of Higher Education—TANSCHE for financial support in the form of M.Sc., “Student Mini Project” to Ms. L. Preethi.

Author information

Authors and Affiliations

  1. Department of Biochemistry, Bharathi Womens College, Chennai, India

    Preethi Loganathan & Fathima Kader Afel

  2. Department of Biochemistry, Vel’s University, Chennai, India

    Sampath Kumar Gasper

  3. Department of Biochemistry, Billroth Hospitals, Chennai, 600030, India

    Selvakumar Kandaswamy

  4. Indian Association of Basic Paramedical Sciences, Chennai, India

    Selvakumar Kandaswamy

Authors
  1. Preethi Loganathan
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  2. Sampath Kumar Gasper
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  3. Fathima Kader Afel
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  4. Selvakumar Kandaswamy
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Corresponding author

Correspondence to Selvakumar Kandaswamy.

Appendix: Table For Mixing Delay, Centrifugation Delay And Analysing Delay

Appendix: Table For Mixing Delay, Centrifugation Delay And Analysing Delay

Group 1

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

1a, 2a, 3a, 4a, 5a

2

Time taken from blood shed to centrifuge

Immediately centrifuge (< 10 min)

     

1b, 2b, 3b, 4b, 5b

4

     

1c, 2c, 3c, 4c, 5c

6

     

1d, 2d, 3d, 4d, 5d

8

     

1e, 2e, 3e, 4e, 5e

10

     
  1. Sample ID will be designated in serial nos. 1–5 the same samples will be taken for variable time of mixing

Group 2

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

6a, 7a, 8a, 9a, 10a

2

Time taken from blood shed to centrifuge

Immediately centrifuge (30 min)

     

6b, 7b, 8b, 9b, 10b

4

6c, 7c, 8c, 9c, 10c

6

6d, 7d, 8d, 9d, 10d

8

6e, 7e, 8e, 9e, 10e

10

  1. Sample ID will be designated in serial nos. 6–10 the same samples will be taken for variable time of mixing

Group 3

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

11a, 12a, 13a, 14a, 15a

2

Time taken from blood shed to centrifuge (1.00 h)

     

11b, 12b, 13b, 14b, 15b

4

     

11c, 12c, 13c, 14c, 15c

6

     

11d, 12d, 13d, 14d, 15d

8

     

11e, 12e, 13e, 14e, 15e

10

     
  1. Sample ID will be designated in serial nos. 11–15 the same samples will be taken for variable time of mixing

Group 4

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

16a, 17a, 18a, 19a, 20a

2

Time taken from blood shed to centrifuge (1.30 h)

     

16b, 17b, 18b, 19b, 20b

4

16c, 17c, 18c, 19c, 20c

6

16d, 17d, 18d, 19d, 20d

8

16e, 17e, 18e, 19e, 20e

10

  1. Sample ID will be designated in serial nos. 16–20 the same samples will be taken for variable time of mixing

Group 5

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

21a, 22a, 23a, 24a, 25a

2

Time taken from blood shed to centrifuge (2.00 h)

     

21b, 22b, 23b, 24b, 25b

4

21c, 22c, 23c, 24c, 25c

6

21d, 22d, 23d, 24d, 25d

8

21e, 22e, 23e, 24e, 25e

10

  1. Sample ID will be designated in serial nos. 21–25 the same samples will be taken for variable time of mixing

Group 6 (EDTA Sample)

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

26a, 27a, 28a, 9a, 30a

2

Time taken from blood shed to centrifuge (1 h .30 min)

     

31b, 32b, 33b, 34b, 35b

4

36c, 37c, 38c, 39c, 40c

6

41d, 42d, 43d, 44d, 45d

8

46e, 47e, 48e, 49e, 50e

10

  1. Sample ID will be designated in serial nos. 1–5 the same samples will be taken for variable time of mixing

Group 7 (Serum Sample)

No samples

No of time inverted

 

Time taken from completion of centrifuge to analyze

< 10 min

30 min

1.00 h

1.30 h

2.00 h

51a, 52a, 53a, 54a, 55a

2

Time taken from blood shed to centrifuge (1 h .30 min)

     

56b, 571b, 58b, 59b, 60b

4

     

61c, 62c, 63c, 64c, 65c

6

     

66d, 67d, 8d, 69d, 70d

8

     

71e, 72e, 73e, 74e, 75e

10

     
  1. Sample ID will be designated in serial nos. 1–5 the same samples will be taken for variable time of mixing

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Loganathan, P., Gasper, S.K., Afel, F.K. et al. Pre-analytical Errors in Glucose Estimation Results in Query on Diabetic Management. Ind J Clin Biochem 35, 32–42 (2020). https://doi.org/10.1007/s12291-018-0782-6

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  • DOI: https://doi.org/10.1007/s12291-018-0782-6

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