August, 2022. The Lab Medicine Update is a collaboration between the UVA Medical Laboratories and the UVA Clinical Laboratory Stewardship Subcommittee. Feedback on the LMU? Contact Jim Harrison (james.harrison@virginia.edu).
Modifications in orderable Glucose Tolerance Tests ↑
The UVA Medical Laboratory is retiring glucose tolerance tests (GTT) from the orderable test menu that do not meet American Diabetes Association (ADA) guidelines, and is renaming three of the four remaining GTTs for clarity. These changes are being made after review by the Clinical Laboratory Stewardship Subcommittee, discussion with clinical services including Endocrine, Cystic Fibrosis, Transplant, and Obstetrics, and discussion in the Patient Care Committee. The change was initially approved and reported last year but its implementation was delayed because of information system issues. The change will occur during the week of August 8.
The retained GTTs and their name changes are:
- The current GLUCOSE TOLERANCE (FAST & 2HR ONLY) PANEL [LAB6010]
Is being renamed GLUCOSE TOLERANCE (NON-GESTATIONAL DIABETES) PANEL - The current GLUCOSE TOLERANCE, 2HR W 90 MIN PANEL [LAB6083]
Is being renamed GLUCOSE TOLERANCE (GROWTH HORMONE SUPPRESSION) PANEL - The current GLUCOSE TOLERANCE, 3HR (GESTATIONAL) GTT PANEL [LAB6009]
Is being renamed GLUCOSE TOLERANCE (GESTATIONAL DIABETES) PANEL - The current GESTATIONAL DIABETES SCREEN [LAB879] is being retained without change
The ADA guidelines for glucose tolerance testing are available at:
ADA. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. Diabetes Care 2021;44(Suppl. 1):S15–S33. https://doi.org/10.2337/dc21-S002
Hazelnut components IgE allergy test available ↑
The Davis Laboratory is now performing hazelnut components in-house on the Phadia 250 system, which is used for all IgE allergy testing. The test is LAB6488 Allergen Hazelnut Components IgE (HZLNCP) and includes four results:
COR A 1 (PR10), COR A 8 (LTP), COR A 9, COR A 14
The analytical measurement range is 0.10 – 100 kU/L with a reference range of <0.35 kU/L considered negative. The assay requires one gold top tube and can be combined with other allergy requests.
Walnut components IgE allergy test available ↑
The Davis Laboratory is now performing walnut components in-house on the Phadia 250 system, which is used for all IgE allergy testing. The test is LAB6489 Allergen Walnut Components IgE (WLNCP) and includes results:
JUG r 1 and JUG r 3 (LTP)
The analytical measurement range is 0.10 – 100 kU/L with a reference range of <0.35 kU/L considered negative. The assay requires one gold top tube and can be combined with other allergy requests.
New amphetamine urine drug confirmation cutoff ↑
The Toxicology Laboratory has validated a lower cutoff for urine amphetamine drug confirmations. Any confirmation result >50 ng/mL is now considered positive for amphetamine, methamphetamine, MDA, and MDMA. The sample requirements have not changed.