Gestational Diabetes Mellitus and Glucose Sample Handling.

Abstract

Gestational diabetes mellitus (GDM) continues to provide challenges in terms of both diagnosis and management. Recent scientific discussions around the preanalytical processing of glucose samples from the glucose tolerance test (GTT) have generated considerable interest and debate (1,2). For most women, the diagnosis of GDM is based on the measurement of plasma glucose after the GTT. The observational Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study (3) and the consensus agreement about diagnostic criteria by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) (4) provided glucose thresholds for the diagnosis of GDM. The HAPO study was meticulous in the preanalytical and analytical processing of glucose samples (3). Given that our current diagnostic criteria are based on the findings of the HAPO study, if results are to be comparable, the same meticulous processing must also be applied to glucose samples processed in routine clinical care. A major source of preanalytical error in measuring glucose is loss of glucose from blood samples …