Research article: Validation of Fluoride Oxalate against Iodide Oxalate, Chloride Oxalate, and Glucomedics Anticoagulants for Glucose Estimation

 

Onyeaghala Augustine, Nurudeen Adebisi, Adigun Abbas and Chinedum Babalola

 

Abstract

Objective: Accurate measurement of glucose is critical for diabetic care. Sodium fluoride/potassium oxalate (NaF/KOx) has been the preferred tube for measuring glucose. Pre-analytical challenges associated with the use of NaF/KOx and the emergence of COVID-19 presented challenges in the purchase of preservatives for measuring glucose. The need to validate other available and accessible local pres­er­vatives for measuring glucose became necessary. This study aimed to validate glucose values using standard NaF/KOx anticoagulant against iodide oxalate, chloride oxalate, and glucomedics anticoagulant.

Methods: Blood samples were collected from 45 apparently healthy individuals and distributed into four tubes: NaF/KOx, sodium chloride/potassium oxalate (NaCl/KOx), Iodide oxalate/potassium oxalate (IOx/KOx), and glucomedics. Samples were separated into aliquots and stored for various durations before centrifugation. Glucose analysis was measured using the glucose oxidase-peroxi­dase method. Statistical analysis included bias comparison, mean concentration comparison, Deming’s regression, and Bland-Altman analysis.

Result: There was a significant decrease in glucose concentration with an increasing in sample separation time. Glucomedics showed minimal decrease, exhibited the least bias in all time points considered with only 1-hour delayed measurement having a clinically acceptable bias of 1.62<2.2%; and demonstrated the strongest correlation with other methods. Mean concentration differences were comparable between glucomedics and NaF/KOx.

Conclusion: The three different anticoagulants could be a good replacement for NaF/KOx. However, glucose values obtained using glucomedics could give a better clinically useful result than others when a delay in sample processing is inevitable. The need to consider the use of any of the anticoagulants in place of NaF/KOx is strongly recommended.

Keywords: Anticoagulants, Diabetics, NaF/KOx, Glucomedics, Glucose estimation, Iodide Oxalate, Chloride Oxalate.

Int. J. Bio. Lab. Sci 2024(13)2:118-130  【PDF】


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