AGS Éste Málaga-Axarquía
HbA1C DETERMINATION. IMPACT ON THE CONTROL OF DIABETES
José de la Torre Fernández; Francisco M. Rodríguez Peña; Gema Soriano Bueno; José de la Torre Navarrete; Soledad Sánchez-Montes Moreno; Federico Navajas Luque UGC Laboratorio Clínico. Hospital Comarcal de la Axarquía (Vélez-Málaga). Málaga. Spain INTRODUCTION
RESULTS:
Hemoglobin A1C is an average measure of glucose levels in recent months, while a blood glucose test only indicates the status of diabetes control in a certain point. It is a determination used for tracking and monitoring the treatments in patients with diabetes. Due to the absence in the bibliography of studies about the stability of the glycosylated hemoglobin in relation with room temperature, we consider appealing to study what happens with samples that for any reason suffer, during the process from the extraction to the analytical determination, an interruption in the cold chain.
The results obtained on the trial underwent a statistic treatment of Student’s “t” with a significance level of p<0.05. Total Hb (Figure 3) did not suffer any significant modification (p=0.007), at controlled room temperature in the first five days of the trial. However, in Hb A1C (Figure 2), it appears significant modifications from the fifth day (p=0.17).
% Hb A1C
OBJECTIVES:
Hb A1C
To study the stability, at controlled room temperature of the laboratory, of Hb A1C and total Hb.
Figure 2
120 % 110 % 100 % 90 % 80 % 70 % 60 % 50 %
Basal 5 Day 7 Day 10 Day 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Samples
Total Hb
Figure 3
110 %
% Total Hb
100 % Basal 5 Day
90 % 80 %
7 Day 10 Day
70 % 60 % 50 % 0 1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132333435363738394041424344454647484950 Samples
CONCLUSIONS:
Figure 1 MATERIAL AND METHODS: For our study it has been used a total number of fifty blood samples, taken from diabetic patients and contained in tubes with EDTA anticoagulant. Total hemoglobin was determined with a Sysmex XE2100 automated analyzer (Figure 1). Glycated hemoglobin was analyzed by high resolution liquid chromatography in an Adams A1C HA-8160 analyzer (Menarini Diagnostics), at intervals of time: 2 hours, 5, 7 and 10 days. Samples were maintained throughout the study at a controlled room temperature (23 ± 1° C).
According to obtained data, at controlled room temperature (23 ± 1° C), the results of total hemoglobins are valid until the fifth day from the extraction, not being essential a refrigerated storage of the samples during this period. However, for the analysis of Hb A1C it is necessary to refrigerate them and analyze the samples before the fifth day of the extraction to avoid major variations of 2.7% (variation value recommended by SEQC). From the fifth day, the decrease between the 5 and 10% of Hb A1C values override the clinic usefulness of sample analysis at room temperature, for an accurate control of diabetic patients whose value limits for a proper monitoring has to be <7.5% of Hb A1C.