Italian 
English Adesione alle raccomandazioni dei gruppi di studio SIBioC-SIPMeL (Società Italiana di Patologia Clinica e Medicina di Laboratorio) e SID (Società Italiana di Diabetologia) sulla fase preanalitica per la determinazione della glicemia: ancora margini di miglioramento. Risultati di una indagine conoscitiva nazionale
Adherence to the recommendations of the SIBioC-SIPMeL (Società Italiana di Patologia Clinica e Medicina di Laboratorio) and SID (Società Italiana di Diabetologia) study groups on the preanalytical phase for blood glucose measurement: still room for improvement. A National Survey on the state of art.
AUTORI
1Centro Regionale di Riferimento per la Verifica Esterna di Qualità, Azienda Ospedaliero Universitaria Careggi, Firenze
2,3Laboratorio di Chimica Clinica ed Ematologia, Ospedale San Bortolo, Vicenza
4SIPMeL, Castelfranco Veneto, Treviso
5Dipartimento di Fisiopatologia medico-chirurgica e dei Trapianti, Università degli Studi, Milano6Laboratorio di Patologia Clinica, ASST-Valcamonica, Esine, Brescia
ABSTRACT
Adherence to the recommendations of the SIBioC-SIPMeL (Società Italiana di Patologia Clinica e Medicina di Laboratorio) and SID (Società Italiana di Diabetologia) study groups on the preanalytical phase for blood glucose measurement: still room for improvement. A National Survey on the state of art.
Introduction: glucose measurement is pivotal in the management of subjects with diabetes mellitus. Laboratories should provide the most useful information to the clinician in order to ensure the best patient outcome.
Methods: in October 2019 a survey has been conducted by SIBioC and SIPMeL Study Groups on “Diabetes Mellitus” and by the Italian Diabetes Society to verify if their recommendations on preanalytical phase have had an impact on Italian laboratory procedures. Fifteen questions were submitted to all SIBioC and SIPMeL members and 190 complete responses were collected, corresponding to around 5% of all Italian laboratories.
Results: 74% of the laboratories (n=46) are aware of the recommendations of the “Diabetes Mellitus” Study Groups, but only 24% apply them. 61% of the first group centrifuges the collection tubes immediately, providing a rapid plasma separation; 9% place the tubes immediately in an ice-water slurry and separate the plasma within 30 minutes. Only 14 of the responders use citrate buffer/sodium EDTA/sodium fluoride (NaF) tube in lyophilic formulation.
The survey allowed to determine also which kind of tube is commonly used: for outpatients, 52 (30%) laboratories use serum or heparinized tubes with separator gel, 46 (24%) of the remaining of laboratories use NaF plasma and heparinized plasma tubes. For hospitalized patients, 99 (52%) laboratories utilizes tubes with separator gel or coagulation activator, while 19 (10%) and 15 (8%) respectively use NaF plasma and heparinized plasma. To perform the Oral Glucose Tolerance Test (OGTT), 84 (43%) laboratories uses tubes without glycolysis inhibitors or separator gel, and only 12 laboratories uses tubes with acidified ternary mixture.
Conclusion: considering these non-completely satisfactory findings, the educational activity of SIBioC working groups on “Diabetes Mellitus” and “Variability of Extra-analytical phase” should be continued, since they appear to be essential for the improvement of the laboratory procedures.