How to perform pregnancy diabetes screening correctly

S. A.A. Van Den Berg*, M. J.M. De Groot, L. P.W. Salden, P. J.G.J. Draad, I. M. Dijkstra, S. Lunshof, S. W. Van Thiel, K. J.M. Boonen, M. H.M. Thelen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Pregnancy diabetes (GDM) is associated with both higher rates of morbidity and mortality, and is diagnosed in thousands of women each year (1). Fasting glucose and glucose tolerance tests form the backbone of diagnosis. Since in most cases the diagnosis is based on a single laboratory assessment, any (pre)analytical error may result in a faulty diagnosis. Here, we shortly describe our recent studies in the context of optimization of pregnancy diabetes screening. Currently, the global update of GDM guidelines based on the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study (2) has sparked fierce debate, as the protocol that needs to be followed to use these new cut-off values are cumbersome, expensive and hard to comply to (3). More specific, this protocol calls for a turn-around-time (TAT) of pre-analysis of less than 5 minutes, cooling of phlebotomy tubes in ice and immediate freezing or measurement of isolated plasma after centrifugation. Deviation from these procedures most likely results in underdiagnosis (3). In vitro, glucose levels start to drop immediately after phlebotomy due to glycolysis. To minimize glycolysis, one should place the sample tube in an ice-water slurry, and plasma should be separated from the cells within 30 min. If that cannot be achieved, a tube containing a rapidly effective glycolysis inhibitor should be used for collecting the sample. Importantly, tubes with only enolase inhibitors (i.e. sodium fluoride) should not be relied on to prevent glycolysis as sodium-fluoride is far from capable to prevent glucose loss during the first hours after phlebotomy (4).

Original languageEnglish
Pages (from-to)198-199
Number of pages2
JournalNederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde
Issue number3
Publication statusPublished - Jul 2016


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