Pre-Analytical Stability of Fasting Blood Glucose: A Comparison Between Immediate Analysis and Two-Hour Room Temperature Storage

Sugito Sugito; Herlinda Djohan; Sri Tumpuk; Alfino Validita Sidiq; Dexa Agum

doi:10.30602/jlk.v9i1.2138

Pre-Analytical Stability of Fasting Blood Glucose: A Comparison Between Immediate Analysis and Two-Hour Room Temperature Storage

Sugito Sugito, Herlinda Djohan, Sri Tumpuk, Alfino Validita Sidiq, Dexa Agum

Abstract

The stability of blood samples for glucose testing is a critical preanalytical factor. In vitro glycolysis at room temperature can significantly decrease glucose levels, potentially leading to inaccurate diagnostic results. This study aimed to compare fasting blood glucose levels examined immediately and those stored for 2 h at room temperature. This descriptive, cross-sectional study involved 35 serum samples from participants undergoing fasting blood glucose tests at the Sintang Regional Health Laboratory. Each sample was split into two aliquots: one was analyzed immediately after processing (baseline), and the other was analyzed after being stored for 2 hours at room temperature (25-30°C). Glucose levels were measured using the GOD-PAP method with a Microlab 300 spectrophotometer. Statistical analysis was performed using the Shapiro-Wilk normality test and paired T-test to compare the differences in glucose levels between the two groups. The mean glucose level examined immediately was 90.8 mg/dL (SD=5.098), while the level after the 2-hour delay was 85.8 mg/dL (SD=4.451), showing an average decrease of 5.0 mg/dL. The data were normally distributed (p=0.129), and the paired T-test showed a highly statistically significant difference (p<0.001) between the two examination conditions. Storing serum samples at room temperature for 2 h significantly decreased glucose levels. This finding underscores the importance of immediate sample processing for glucose testing to ensure accurate diagnosis. If a delay is unavoidable, sample refrigeration is highly recommended to inhibit the glycolysis process.

Keywords

Fasting Blood Glucos;, Sample Stabilit;, Room Temperatur;, Glycolysis; Pre-Analytical Factor;, GOD-PAP

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References

Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Lernmark Å, et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Diabetes Care 2023;46:e151–99. https://doi.org/10.2337/dci23-0036.

Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Lernmark Å, et al. Executive Summary: Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Diabetes Care 2023;46:1740–6. https://doi.org/10.2337/dci23-0048.

Miller E, Gavin JR, Brunton SA, Kruger DF. Continuous Glucose Monitoring: Optimizing Diabetes Care: Executive Summary. Clinical Diabetes 2022;40:394–8. https://doi.org/10.2337/cd22-0043.

Klaff L, Zondorak D, Wayland-Smith A, Richardson JM, Vernes P, Shelat P. Accuracy and User Performance of a New Blood Glucose Monitoring System. J Diabetes Sci Technol 2020;15:1382–9. https://doi.org/10.1177/1932296820974348.

Zafar H, Channa A, Jeoti V, Stojanović GM. Comprehensive Review on Wearable Sweat-Glucose Sensors for Continuous Glucose Monitoring. Sensors 2022;22:638. https://doi.org/10.3390/s22020638.

Zhou J, Fabros A, Lam SJ, Coro A, Di Meo A, Brinc D, et al. The stability of 65 biochemistry analytes in plasma, serum, and whole blood. Clin Chem Lab Med 2024;62:1557–69. https://doi.org/10.1515/cclm-2023-1192.

Ni X, Lu C-P, Xu G-Q, Ma J-J. Transcriptional regulation and post-translational modifications in the glycolytic pathway for targeted cancer therapy. Acta Pharmacol Sin 2024;45:1533–55. https://doi.org/10.1038/s41401-024-01264-1.

Fuller GG, Kim JK. Compartmentalization and metabolic regulation of glycolysis. J Cell Sci 2021;134. https://doi.org/10.1242/jcs.258469.

Holt V, Colbert RA, Morén B, Fryklund C, Stenkula KG. Acute cytokine treatment stimulates glucose uptake and glycolysis in human keratinocytes. Cytokine 2023;161:156057. https://doi.org/10.1016/j.cyto.2022.156057.

Xiang C, Wang F, Sun A, Zhang G, Zhou D, Chen Q, et al. Increased glycolysis in skeletal muscle coordinates with adipose tissue in systemic metabolic homeostasis. J Cell Mol Med 2021;25:7840–54. https://doi.org/10.1111/jcmm.16698.

Wang R-H, Chen Y-C, Wang L-H, Wang W-C, Wang LH-C, Lin K-T, et al. Hydrogen sulfide coordinates glucose metabolism switch through destabilizing tetrameric pyruvate kinase M2. Nat Commun 2024;15. https://doi.org/10.1038/s41467-024-51875-9.

Poland DCW, Cobbaert CM. Blood self-sampling devices: innovation, interpretation and implementation in total lab automation. Clin Chem Lab Med 2024;63:3–13. https://doi.org/10.1515/cclm-2024-0508.

Ashworth M, Small B, Oldfield L, Evans A, Greenhalf W, Halloran C, et al. The holding temperature of blood during a delay to processing can affect serum and plasma protein measurements. Sci Rep 2021;11. https://doi.org/10.1038/s41598-021-85052-5.

Gu M, Zhou X, Yang J, Jie Z, Zhu L, Zheng X, et al. NF-κB-inducing kinase maintains T cell metabolic fitness in antitumor immunity. Nat Immunol 2021;22:193–204. https://doi.org/10.1038/s41590-020-00829-6.

Li C, Han F-J, Liu F-Y, Tian Y, Shen Y. Research progress on the mechanism of glycolysis in ovarian cancer. Front Immunol 2023;14. https://doi.org/10.3389/fimmu.2023.1284853.

Detudom R, Chen S, Wei H, Boran H, Deetae P, Prakitchaiwattana C, et al. Dynamic Changes in Physicochemical and Microbiological Qualities of Coconut Water during Postharvest Storage under Different Conditions. Horticulturae 2023;9:1284. https://doi.org/10.3390/horticulturae9121284.

Soh SX, Loh TP, Sethi SK, Ong L. Methods to reduce lipemic interference in clinical chemistry tests: a systematic review and recommendations. Clin Chem Lab Med 2021;60. https://doi.org/10.1515/cclm-2021-0979.

Howard LA, Lidbury JA, Jeffery N, Washburn SE, Patterson CA. Evaluation of a flash glucose monitoring system in nondiabetic dogs with rapidly changing blood glucose concentrations. J Vet Intern Med 2021;35:2628–35. https://doi.org/10.1111/jvim.16273.

DOI: https://doi.org/10.30602/jlk.v9i1.2138