Main Article Content
Abstract
Highlights:
1. Research on the effect of blood volume proportion in the examination of HbA1c levels using K2EDTA anticoagulantvhas yet to be widely carried out in Indonesia.
2. The analysis conducted utilizing K2EDTA tubes revealed that the varying proportions of blood samples had no effectvon HbA1c levels.
3. This article highlights the necessity of evaluating the pre-analytical phase (sample preparation) of a laboratory process to improve the accuracy of the results and minimize false high or low results in the HbA1c test.
Abstract
Hemoglobin A1c (HbA1c) examination is the gold standard for diagnosing and monitoring diabetes mellitus patients. In the examination, the pre-analytical phase has the most considerable error rate at 61%. One of the contributing factors is the use of anticoagulants that do not adhere to established guidelines. Additionally, the incompatibility of the sample volume proportions and the anticoagulants in K2EDTA tubes has been observed in numerous cases. The significance of HbA1c testing, particularly in the prevention of diabetes complications, underscores the need for appropriate procedures to be followed throughout the sampling and pre-analytical phases. This study aimed to determine the effect of differences in the proportion of blood sample volume and anticoagulants in K2EDTA tubes on HbA1c levels. This research was conducted in August–September 2022. The research samples were collected from the staff and students at the Department of Medical Laboratory Technology, Politeknik Kesehatan Kemenkes Surabaya, Surabaya, Indonesia. The blood samples were divided into K2EDTA tubes with varying volumes of 1 mL, 2 mL, 3 mL, and 4 mL. The HbA1c levels were then examined at the Clinical Chemistry Laboratory of Politeknik Kesehatan Kemenkes Surabaya. The data were analyzed using a one-way ANOVA test. The statistical test results (p>0.05) indicated that the proportion of samples containing anticoagulants in the K2EDTA tubes did not have any significant effect on HbA1c levels. In conclusion, it is acceptable to utilize K2EDTA tubes with varying blood sample volumes for the measurement of HbA1c levels.
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References
- Cahyani RWD (2018). Pengaruh jumlah volume darah dalam tabung vacutainer K2EDTA dan K3EDTA terhadap pemeriksaan darah lengkap (thesis). Available at: https://repository.poltekkes bdg.info/items/show/3129.
- Dayalan S, Subbarayan D, Radha RN, et al (2020). Underfilled K2EDTA vacutainer on automated haematological blood cell indices to reject or reconsider? Journal of Clinical and Diagnostic Research. doi: 10.7860/JCDR/2020/43292.13578.
- Gupta V, Mittal S, Negi G, et al (2014). Under filled di potassium-ethylene di amine tetra acetic acid vacutainers and its effect on automated blood cell indices in healthy blood donors: Is there a need to re-investigate it as a rejection criterion? Journal of Applied Hematology 5, 101. doi: 10.4103/1658-5127.141997.
- Infodatin (2020). Tetap prodiktif, cegah dan atasi diabetes melitus. Infodatin. Available at: https://www.kemkes.go.id/downloads/resources/download/pusdatin/infodatin/Infodatin2020Diabetes Melitus.pdf.
- International Diabetes Federation (2017). IDF diabetes atlas eight edition 2017. IDF. Available at: https://diabetesatlas.org/upload/resources/previ ous/files/8/IDF_DA_8e-EN-final.pdf.
- Putri AES, Larasati T (2013). Hubungan obesitas dengan kadar HbA1c pasien diabetes melitus tipe 2 di laboratorium patologi klinik rumah sakit umum daerah Abdul Moeloek. Medical Journal of Lampung University. Available at: https://juke. kedokteran.unila.ac.id/index.php/majority/article/view/57/56.
- Que A, Yasa IWPS, Lestari AAW (2015). Gambaran hasil pemeriksaan kadar Hba1c pada penderita diabetes mellitus di Laboratorium Rumah Sakit Umum Surya Husadha Tahun 2013. Jurnal Medika Udayana. Available at: https://ojs.unud.ac.id/index.php/eum/article/view/20919.
- Ramadhan N, Marissa N (2015). Karakteristik penderita diabetes mellitus tipe 2 berdasarkan kadar HBA1c di Puskesmas Jayabaru Kota Banda Aceh. Sel. doi: 10.22435/sel.v2i2.4637.49-56.
- Rawal G, Yadav S, Kumar R, et al (2016). Glycosylated hemoglobin (HbA1C): A brief overview for clinicians. Indian Journal of Immunology and Respiratory Medicine 1, 33–36. Available at: https://www.ijirm.org/journal-article-file/2224.
- Sarihati IGAD, Karimah HN, Habibah N (2019). Gambaran kadar HbA1C pada pasien diabetes melitus tipe 2 di RSUD Wangaya. Meditory : The Journal of Medical Laboratory 6, 88–98. doi: 10.33992/m.v6i2.442.
- Sartika F, Hestiani N (2019). Kadar HbA1c pada pasien wanita penderita diabetes mellitus tipe 2 di Rsud Dr. Doris Sylvanus Palangka Raya. Borneo Journal of Medical Laboratory Technology 2, 97–100. doi: 10.33084/bjmlt.v2i1.1086.
- Sherwani SI, Khan HA, Ekhzaimy A, et al (2016). Significance of HbA1c test in diagnosis and prognosist of diabetic patients. Biomarker Insights 11, BMI.S38440. doi: 10.4137/BMI.S38440.
- Sujarweni VW (2013). SPSS untuk paramedis. Gava Media.
- Sulistio G, Mutiara H (2015). Pemeriksaan kadar HbA1c pada pasien diabetes melitus tipe 2 dengan obesitas. Jurnal Kesehatan dan Agromedicine. Available at: https://juke.kedokteran.unila.ac.id/ index.php/agro/article/view/1230.
- Utomo MRS, Wungouw H, Marunduh S (2015). Kadar HbA1C pada pasien diabetes melitus tipe 2 di Puskesmas Bahu Kecamatan Malalayang Kota Manado. eBiomedik. doi: https://doi.org/10.35790 /ebm.v3i1.6620.
- Wulandari IAT, Herawati S, Wande IN (2020). Gambaran kadar HbA1C pada pasien diabetes melitus tipe II di RSUP Sanglah periode Juli-Desember 2017. J Med Udayana. Available at: https://ojs.unud.ac.id/index.php/eum/article/view/58263.
- Yaqin A (2015). Analisis tahap pemeriksaan pra analitik sebagai upaya peningkatan mutu hasil laboratorium Di RS. Muji Rahayu Surabaya. J Sains. Available at: https://journal.unigres.ac.id/ index.php/Sains/article/view/591.
- Yedla N, Kuchay M, Mithal A (2015). Hemoglobin E disease and glycosylated hemoglobin. Indian Journal of Endocrinology and Metabolism 19, 683. doi: 10.4103/2230-8210.163211.
References
Cahyani RWD (2018). Pengaruh jumlah volume darah dalam tabung vacutainer K2EDTA dan K3EDTA terhadap pemeriksaan darah lengkap (thesis). Available at: https://repository.poltekkes bdg.info/items/show/3129.
Dayalan S, Subbarayan D, Radha RN, et al (2020). Underfilled K2EDTA vacutainer on automated haematological blood cell indices to reject or reconsider? Journal of Clinical and Diagnostic Research. doi: 10.7860/JCDR/2020/43292.13578.
Gupta V, Mittal S, Negi G, et al (2014). Under filled di potassium-ethylene di amine tetra acetic acid vacutainers and its effect on automated blood cell indices in healthy blood donors: Is there a need to re-investigate it as a rejection criterion? Journal of Applied Hematology 5, 101. doi: 10.4103/1658-5127.141997.
Infodatin (2020). Tetap prodiktif, cegah dan atasi diabetes melitus. Infodatin. Available at: https://www.kemkes.go.id/downloads/resources/download/pusdatin/infodatin/Infodatin2020Diabetes Melitus.pdf.
International Diabetes Federation (2017). IDF diabetes atlas eight edition 2017. IDF. Available at: https://diabetesatlas.org/upload/resources/previ ous/files/8/IDF_DA_8e-EN-final.pdf.
Putri AES, Larasati T (2013). Hubungan obesitas dengan kadar HbA1c pasien diabetes melitus tipe 2 di laboratorium patologi klinik rumah sakit umum daerah Abdul Moeloek. Medical Journal of Lampung University. Available at: https://juke. kedokteran.unila.ac.id/index.php/majority/article/view/57/56.
Que A, Yasa IWPS, Lestari AAW (2015). Gambaran hasil pemeriksaan kadar Hba1c pada penderita diabetes mellitus di Laboratorium Rumah Sakit Umum Surya Husadha Tahun 2013. Jurnal Medika Udayana. Available at: https://ojs.unud.ac.id/index.php/eum/article/view/20919.
Ramadhan N, Marissa N (2015). Karakteristik penderita diabetes mellitus tipe 2 berdasarkan kadar HBA1c di Puskesmas Jayabaru Kota Banda Aceh. Sel. doi: 10.22435/sel.v2i2.4637.49-56.
Rawal G, Yadav S, Kumar R, et al (2016). Glycosylated hemoglobin (HbA1C): A brief overview for clinicians. Indian Journal of Immunology and Respiratory Medicine 1, 33–36. Available at: https://www.ijirm.org/journal-article-file/2224.
Sarihati IGAD, Karimah HN, Habibah N (2019). Gambaran kadar HbA1C pada pasien diabetes melitus tipe 2 di RSUD Wangaya. Meditory : The Journal of Medical Laboratory 6, 88–98. doi: 10.33992/m.v6i2.442.
Sartika F, Hestiani N (2019). Kadar HbA1c pada pasien wanita penderita diabetes mellitus tipe 2 di Rsud Dr. Doris Sylvanus Palangka Raya. Borneo Journal of Medical Laboratory Technology 2, 97–100. doi: 10.33084/bjmlt.v2i1.1086.
Sherwani SI, Khan HA, Ekhzaimy A, et al (2016). Significance of HbA1c test in diagnosis and prognosist of diabetic patients. Biomarker Insights 11, BMI.S38440. doi: 10.4137/BMI.S38440.
Sujarweni VW (2013). SPSS untuk paramedis. Gava Media.
Sulistio G, Mutiara H (2015). Pemeriksaan kadar HbA1c pada pasien diabetes melitus tipe 2 dengan obesitas. Jurnal Kesehatan dan Agromedicine. Available at: https://juke.kedokteran.unila.ac.id/ index.php/agro/article/view/1230.
Utomo MRS, Wungouw H, Marunduh S (2015). Kadar HbA1C pada pasien diabetes melitus tipe 2 di Puskesmas Bahu Kecamatan Malalayang Kota Manado. eBiomedik. doi: https://doi.org/10.35790 /ebm.v3i1.6620.
Wulandari IAT, Herawati S, Wande IN (2020). Gambaran kadar HbA1C pada pasien diabetes melitus tipe II di RSUP Sanglah periode Juli-Desember 2017. J Med Udayana. Available at: https://ojs.unud.ac.id/index.php/eum/article/view/58263.
Yaqin A (2015). Analisis tahap pemeriksaan pra analitik sebagai upaya peningkatan mutu hasil laboratorium Di RS. Muji Rahayu Surabaya. J Sains. Available at: https://journal.unigres.ac.id/ index.php/Sains/article/view/591.
Yedla N, Kuchay M, Mithal A (2015). Hemoglobin E disease and glycosylated hemoglobin. Indian Journal of Endocrinology and Metabolism 19, 683. doi: 10.4103/2230-8210.163211.