Laboratory Tests Flashcards
Requested during insulin shock and hyperglycemic ketonic coma
RV:
RANDOM PLASMA GLUCOSE
RV: <160 mg/dL
If RBS >160 mg/dL, perform:
FBS, HBA1C, 2hrsOGTT for confirmation
Measure of overall glucose homeostasis
Fasting requirement:
RV:
Fasting Plasma Glucose (FBS)
Fasting: 8-12hrs, not more than 16 hours
RV: 70-99 mg/dL
FBS
Impaired Fasting Glucose (IFG):
Diabetic Value:
Increases with age:
Impaired Fasting Glucose (IFG): 100-125 mg/dL
Diabetic Value: >126 mg/dL
Increases with age: 2 mg/dL/decade
2hour Post Prandial Blood Glucose
standardize glucose load:
RV:
standardize glucose load: 75g of glucose
RV: 60 - 140 mg/dL
2hour Post Prandial Blood Glucose
Hyperglycemia:
Diabetic Value:
Increase w/ age:
Hyperglycemia: 140 mg/dL
Diabetic Value: >200 mg/dL (next day, FBS/RBS should be performed)
Increase w/ age: 4mg/dL/decade
Glycosylated = glucose attached to one or both of the _ chain of both beta chains.
terminal valine
Preferred test to assess long-term glycemic control
* Reflects the average glucose level over the past 2-3months
RV:
GLYCOSYLATED HEMOGLOBIN (HbA1c) / GLYCATED HGB
RV:
Adult: 4.0 - 6.0% (American diabetes assoc. <5.7%)
o Pediatrics: <7.5%
HbA1c is dependent of the ff:
- RBC Life Span
- Plasma Glucose Level
HbA1c
Diabetic Value:
Pre-diabetes:
Diabetic Value: equal or >6.5%
Pre-diabetes: 5.7 - 6.4%
Decrease life span is seen in:
Cannot perform HbA1c because it’s going to be low
Hemolytic anemia and Hemoglobinopathies
have FD HbA1c
Fructosamine is also known as
RV:
GLYCOSYLATED/GLYCOLATED ALBUMIN PLASMA PROTEIN KETOAMINE
RV: 205 - 285 umol/L
Substitute for HbA1c for hemolytic anemia and hemoglobinopathies
Useful for patients with decreased RBC life span like _
- Most widely used to assess short-term glycemic control (_)
Fructosamine;
Chronic hemolytic anemia, Hemoglobin C and S
3-6 weeks
Fructosamine can’t be performed on px with hypoalbuminemia (dec
albumin): 30g/dL → since it causes
FD Fructosamine
Fructosamine interferences:
high UA, TGA, Bilirubin, heparin, hepmolysis
It is used to determine how well the body metabolizes glucose over a required period of time.
* Recommended for diagnosis of GDM
* Not routinely performed to diagnose DM
GLUCOSE TOLERANCE TEST /
MULTIPLE SUGAR TEST
two types of Glucose Tolerance Test
Oral Glucose Tolerance Test (OGTT)
Intravenous Glucose Tolerance Test (IVGGT)
Only test in CC not performed on bedridden px
OGTT (px should be ambulatory)
OGTT Glucose Load:
▪ _ = WHO Standard Glucose Load
▪ _ = pregnant; as requested
▪ _= children (maximum of 75g)
▪ 75g = WHO Standard Glucose Load
▪ 100g = pregnant; as requested
▪ 1.75g of glucose/kilogram body weight = children (maximum of
75g)
OGTT Recommended for non-pregnant px:
fasting: atleast 10 hrs (not longer 16hrs)
blood sample is taken after fasting (morning)
standardize glucose load (75g)
blood sample is taken 2 hours after glucose load
OGTT unrestricted diet of _ prior to
testing
150g CHO/day for 3 days
OGTT restrictions
exercise, food intake, drinking, smoking
smoking & alcohol: inc. BG
Performed on patients with gastrointestinal disorders such as
malabsorption syndrome
IVGTT
IVGTT
glucose load:
administered within:
total of blood coll:
glucose load: 0.5 g/KBW
administered within: 3 MINUTES
total of blood coll: 5 samples
IVGTT
2nd sample:
4th sample:
2nd sample: only used to determine if IV is successfully administered
4th sample: used to diagnose DM
