Pathology Handbook

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Glucose

Alternative Names:Random Blood Glucose
Fasting Blood Glucose
Laboratory:Clinical Biochemistry
Test Code:GL or GLFO or GLFOF
Specimen Types:Plasma
Serum
Container Types:
Fluoride Oxalate
Lithium Heparin (with Gel)
SST
Collection & Request Instructions:

Fluoride Oxalate is the preferred sample where testing will be delayed and/or a diagnostic decision is required. For routine monitoring on inpatients serum is suitable.

Retrospective testing only available on  Fluoride Oxalate sample .

Transport Instructions between Sites and/or Laboratories:Room Temperature
Additional Notes:

Reference Intervals:
 
Fasting:     3.5 - 6.0 
mmol/L
  Random:   3.5 - 7.7  mmol/L

Relevant Ref. Intervals effective from 06/06/2013

 

A random glucose > 7.8 mmol/L in inpatients should trigger clinicians to follow the guideline for  “Blood Glucose Monitoring" (Fig 1) in Alfred Health PROMPT.

 

Comments for Glucose for Pathology Handbook

 

 

Blood glucose values vary normally throughout the day especially between pre- and post-prandial levels.  Normal fasting glucose levels are between 3.5 and 6.0 mmol/L, but levels between 5.5 and 6.0 mmol/L indicate an increased risk for diabetes especially for patients designated as high risk for diabetes: people of Aboriginal, Torres Strait Islander, Maori descent, Pacific Islander people, people from the Indian sub-continent, or of Chinese descent aged 35 and over, all people aged 45 or over who have either obesity or hypertension, all people aged 55 and over, and some others (see Joint Position Statement of RCPA and AACB 2008). 

 

Fasting Glucose Levels ≥ 6.1 to 6.9 mmol/L inclusive are defined as impaired fasting glucose and levels of 7 mmol/L and above define diabetes (if asymptomatic should be confirmed with second specimen). An abnormal level of glucose in the absence of diabetes needs to be repeated.

 

Impaired glucose tolerance (IGT, pre diabetes) is defined as values between 7.8 and 11.1 mmol/L at 2h after a 75g glucose load.  Random blood glucose levels ≥ 11.1 mmol/L ( or 2h after a 75g glucose load) on more than one occasion are diagnostic of diabetes.

Beyond the neonatal period hypoglycaemia is defined as glucose levels below 2.5 mmol/L.

Consensus Guidelines now also allow for HbA1c to be used for the diagnosis of Diabetes Mellitus, although it is currently not reimbursed by Medicare (Med J Aust 2012; 197:220-221).

Prof Hans Schneider: 19 August 2013