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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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GLUCOSE, PLASMA, SERUM

Item Value
Available Stat? Yes
Test code GLUC, GLUF
Performed by? Chemistry
Sendout? no
Price range $
In House Availability Routine: 7 days
Stat: 24 hours/7 days
Principle Glucose is phosphorylated in the presence of hexokinase. Glucose-6-phosphate is oxidized in the presence of glucose-6-phosphate dehydrogenase. The associated reduction of NAD to NADH is monitored at 340 nm.
Interpretation 1. Hyperglycemia: Diabetes mellitus, chronic liver disease, pregnancy, uremia, hyperthyroidism, acromegaly, pheochromocytoma, Cushing's syndrome, brain trauma, neoplasms, convulsions, and stress.

2. Hypoglycemia: Increased insulin, sulfonylureas, oral hypoglycemic agents (glyburide, chlorpropamide, etc), propanolol, tumors, glycogen storage disease, malnutrition, hypothyroidism, decreased gluconeogenesis (alcohol, fructose intolerance), liver necrosis, cirrhosis, hepatitis, hepatotoxicity, adrenocortical or pituitary failure, Reye's syndrome, hereditary galactosemia, leucine sensitivity (maple syrup urine disease), decreased catecholamines, post-gastrectomy syndrome, prematurity pregnancy, and pre-eclampsia.
Container type gray top tube (fluoride tube) preferred;
gold or green top gel acceptable
Amount to Collect 2 mL
Collection Instructions If drawn in a gel tube (gold or green), glycolysis occurs at a rate of approximately 5 % per hour.
Sample type Blood
Special instructions Fasting specimen preferred.
Normal range Plasma, serum
Fasting:
Normal 70-99 mg/dL 3.86-5.45 mmol/L
Impaired Fasting
Glucose
(Prediabetes)
100-125 mg/dL 5.51-6.89 mmol/L
Diabetes ≥ 126 mg/dL ≥ 6.94 mmol/L


Random:
Normal mg/dL mmol/L
Age < 1 year 50-150 2.78-8.33
≥ 1 year 70-199 3.89-11.04



Summarized Interpretation of Oral Glucose Tolerance Test

Interpretation 2-hour post load [mg/dL] [mmol/L]
Normal Glucose Tolerance < 140 < 7.77
Impaired Glucose Tolerance 140-199 7.77-11.04
Provisional Diagnosis of Diabetes ≥ 200 ≥ 11.10


The following values are considered Critical Values and are called to the physician or patient care unit immediately.

Critical Values mg/dL mmol/L
Glucose < 50 or > 500 < 2.76 or > 27.55
Neonates < 30 or > 300 < 1.65 or > 16.53
CSF < 30 or > 300 < 1.65 or > 16.53


ADA's 2001 Criteria for Diagnosis of Diabetes

1. Symptoms of diabetes plus a random plasma glucose (PG) level ≥ 200 mg/dL. Typical symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss.

2. Fasting PG level ≥ 126 mg/dL after a minimum eight-hour fast.

3. Two-hour post glucose challenge PG level ≥ 200 mg/dL after an appropriate oral glucose load - the test should be performed as described by the World Health Organization standards, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.

A diagnosis of Diabetes mellitus can be made when any of these initial abnormal findings are confirmed on a subsequent day. Any combination of these findings can be used to diagnose diabetes.

Source: American Diabetes Association

Synonyms Metabolic Basic Panel (METB): NA, K, CL, CO2, CREA, BUN, GLUC, CA;
Stability 72 hours at 2-8°C after separation.
References 1. Diagnosis and Classification of Diabetes Mellitus. American Diabetes Association: Diabetes Care. Volume 29, Supplement 1, January 2006.

2. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Diabetes Care, 20: 1183-97, 1997.

3. Sacks et al., Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus, Clin Chem 48:3; 436-472, 2002.

4. Bayer(TM) Clinical Methods Glucose Hex. II (37) B01-4597-01 Advia 1650 Operator's Guide. PN 073-5001-09. Last accessed June 2003. Siemens Medical Solutions Diagnostics, Malvern, PA.
CPT coding 82947
Last Updated 8/20/2015 8:57:40 AM
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