Neues und Kontroverses zur Blutglukosemessung bei der Diabetesdiagnostik: Konsequenzen der aktualisierten DDG- und AWMF-Leitlinien

New DDG (Deutsche Diabetes-Gesellschaft) and AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) guidelines have been established for the diagnosis of diabetes mellitus and gestational diabetes. These are relevant for blood glucose (BG) measurements with reference to: distinction from HbA_1c measurements; replacement of capillary BG values by venous plasma-derived BG values; and complete preanalytical inhibition of glycolysis. For the first time, BG values derived from standardized unit-use-reagents and their related test systems are accepted (with a mandatory external ring trial system), but only for the screening and diagnosis of gestational diabetes. The Gemeinsamer Bundesausschuss recently recommended a standardized examination of all pregnancies for gestational diabetes and commanded reimbursement of the related costs by health insurers. As there are more than 600,000 pregnancies per year in Germany, this updated diagnostic procedure will expand considerably. It will require considerable competence in clinical chemistry to translate the new guideline standards into the analytical as well as the preanalytical and logistical settings in cooperation with the involved outpatient physicians.