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Hi

 

The site http://www.diagnosticsample.com/samples.php3?lang=en has recently been mentioned on this mail-base and if you type glucose it indicates serum and heparin are not recommended and for glucose ‘10 minutes ↓ (Decrease after this time if not stabilized.)’  I haven’t checked the stats of the original papers.

 

The site is ‘Based on Recommendations of the Working Group on Preanalytical Quality supported by the German Society for Clinical Chemistry and the German Society for Laboratory Medicine. Approved by the Forum of European Societies of Clinical Chemistry (FESCC)’

 

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Regards

Steve

 

 

-----Original Message-----
From: Mainwaring-Burton Richard (RGZ) [mailto:[log in to unmask]]
Sent: 15 November 2007 09:12
To: [log in to unmask]
Subject: Re: Stability of glucose in spun gel barrier Vacutainer

 

Thanks Helen

 

Yes it was late - I am not just a simple sailor - genuine typo

 

The fluoride sample is always higher than the serum

with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
020-8308-3084

-----Original Message-----
From: Grimes, Helen, UCHG [mailto:[log in to unmask]]
Sent: 14 November 2007 18:22
To: Mainwaring-Burton Richard (RGZ)
Subject: RE: Stability of glucose in spun gel barrier Vacutainer

 

Did you mean to say that the serum has never been higher than the fluoride oxalate, or late in the day am I misreading it?

Helen

 

------------------------------------------------------------------------------------

Please note as from now, my new Email address is [log in to unmask] 

Dr Helen Grimes, Consultant Biochemist, Dept Clinical Biochemistry, University Hospital, Galway, Ireland.

  External Tel 00353-91524765. Internal Ext 4607

-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]]On Behalf Of Mainwaring-Burton Richard (RGZ)
Sent: 14 November 2007 17:14
To: [log in to unmask]
Subject: Re: Stability of glucose in spun gel barrier Vacutainer

 

On several occasions we have analysed glucose on both the fluoride and gel samples from a patient, and I can vouch for the fact (observation) that there has never been a fluoride glucose level higher than the serum, and rarely are they the same.  My conclusion is that the glucose declines significantly in the unpreserved sample, moderately in proportion to the delay between sample time and received time.  So much so that I am debating rescinding the permission for non-fluoride samples on out-patient samples collected in the hospital, since these are taking too long to be processed between phlebotomy and centrifuge. 

 

After centrifuging surely the glucose should be protected by the gel from the glycolytic activity of the cells?  Always willing to learn ! 

I would chapter and verse for the "delay in activity of fluoride" please if available.

with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
020-8308-3084

-----Original Message-----
From: Jonathan Kay [mailto:[log in to unmask]]
Sent: 14 November 2007 10:13
To: [log in to unmask]
Subject: Re: Stability of glucose in spun gel barrier Vacutainer

 

I think you'll find:

 

Plasma (or serum) glucose is more stable in the absence of fluoride than expected

A suspicion that there is large between-individual variation in glycolysis

Fluoride is less effective at inhibiting glycolysis than expected, and it still depends on time and temperature

In many countries, and a small number of laboratories in the UK, it is routine practice not to to use fluoride as an inhibitor

 

Good luck

 

Jonathan

 

PS: In Oxford we require a Vacutainer containing fluoride and oxalate. It seems to work OK, much of our transport is unpredictable in delay and temperature, and we think it avoids the problem with patients with high rates of glycolysis. Level of evidence: a few papers and occasional discussions with colleagues. 

 

PPS: Good subject for a systematic review.

 

On 14 Nov 2007, at 08:00, Peadar McGing wrote:

 

Dear colleagues,

Helen Grimes has asked me to pass on the message below to the mailbase as she is having problems with her new email address.

best wishes.

Peadar


Dr Peadar McGing, MRCPath EurClinChem,
Principal Biochemist,
Biochemistry Dept., Mater Misericordiae University Hospital,
Eccles Street, Dublin 7, Ireland.
Tel: (+353 1)8032080;  Fax: (+353 1)8034781.

-----Original Message-----
From: Grimes, Helen, UCHG [mailto:[log in to unmask]]
Sent: 13 November 2007 16:16
To: McGing Peadar (E-mail)
Subject: FW: Stability of glucose in spun gel barrier Vacutainer

Peadar, My Email address has changed again, and I am having trouble getting my new one recognised by JisMail, so could I ask you to forward the attached posting to the ACB Mail base please?

Thanks

Helen

------------------------------------------------------------------------------------

Please note as from now, my new Email address is [log in to unmask] 

Dr Helen Grimes, Consultant Biochemist, Dept Clinical Biochemistry, University Hospital, Galway, Ireland.

  External Tel 00353-91524765. Internal Ext 4607

-----Original Message-----
From: Grimes, Helen, UCHG
Sent: 13 November 2007 15:56
To: 'ACBUK (E-mail)'
Subject: Stability of glucose in spun gel barrier Vacutainer

We advise GPs to leave blood Vacutainer (containing gel) samples stand for an hour prior to centrifuging. A GP has asked if that sample could be used for diabetes screening. The obvious reaction is to say it has to be a fluoride oxalate sample, but if the claim that fluoride oxalate does not inhibit glycolysis until after an hour, should there be a significant difference in the glucose between the two samples? It would reduce workload for the GP and the laboratory if the spun tube was acceptable. Has any one any information for or against this, please?

All the best,

Helen

------------------------------------------------------------------------------------------

Dr Helen Grimes, Dept Clinical Biochemistry, University College Hospital, Galway, Ireland

Please note as from now, my new Email address is [log in to unmask] 

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/

 

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/




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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/