title: Pregnancy diabetes: A comparison of diagnostic protocols based on point-of-care, routine and optimized laboratory conditions.
abstract: In vitro glycolysis poses a problem during diabetes screening, especially in remote laboratories. Point-of-care analysis (POC) may provide an alternative. We compared POC, routine and STAT analysis and a feasible protocol during glucose tolerance test (GTT) for pregnancy diabetes (GDM) screening. In the routine protocol, heparin tubes were used and turn-around-time (TAT) was unsupervised. In the STAT protocol, tubes were processed immediately. The feasible protocol comprised of citrated tubes with a TAT of 1 hour. Outcome was defined as glucose concentration and clinical diagnosis. Glucose measured by POC was higher compared to routine analysis at t = 0 (0.25 mM) and t = 120 (1.17 mM) resulting in 17% more GDM diagnoses. Compared to STAT analysis, POC glucose was also higher, although less pronounced (0.06 and 0.9 mM at t = 0 and t = 120 minutes, respectively) and misclassification was only 2%. Glucose levels and clinical diagnosis were similar using the feasible protocol and STAT analysis (0.03 mM and -0.07 mM at t = 0 and t = 120, 100% identical diagnoses). POC is an viable alternative for STAT glucose analysis in GDM screening (sensitivity: 100%, specificity: 98%). A feasible protocol (citrated phlebotomy tubes with a TAT of 60 minutes) resulted in 100% identical outcome and provides the best alternative.
authors.affiliation: Dept. of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Sjoerd A A
authors.initials: SA
authors.lastname: van den Berg
authors.affiliation: Dept. of Clinical Chemistry, Sint Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Monique J M
authors.initials: MJ
authors.lastname: de Groot
authors.affiliation: Dept. of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Lorenzo P W
authors.initials: LP
authors.lastname: Salden
authors.affiliation: Dept. of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Patrick J G J
authors.initials: PJ
authors.lastname: Draad
authors.affiliation: Dept. of Clinical Chemistry, Sint Anthonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Ineke M
authors.initials: IM
authors.lastname: Dijkstra
authors.affiliation: Dept. of Gynaecology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Simone
authors.initials: S
authors.lastname: Lunshof
authors.affiliation: Dept. of Internal Medicine, Amphia Hospital, Breda, The Netherlands.
authors.forename: Sjoerd W
authors.initials: SW
authors.lastname: van Thiel
authors.affiliation: Dept. of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Kristel J M
authors.initials: KJ
authors.lastname: Boonen
authors.affiliation: Dept. of Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors.forename: Marc H M
authors.initials: MH
authors.lastname: Thelen
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D019095:Point-of-Care Systems; D011247:Pregnancy; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose