Glucose (capillary)

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Fasting or random blood glucose via finger-prick sample. This test is used to determine if your blood glucose level is within a healthy range; if you have symptoms suggesting hypoglycaemia or hyperglycaemia, or if you are pregnant. If you have diabetes, you may be required to monitor glucose levels several times a day.

About

Glucose is a simple sugar that serves as the main source of energy for the body. The carbohydrates we eat are broken down into glucose (and a few other simple sugars), absorbed by the small intestine and circulated throughout the body. Most of the body's cells require glucose for energy production; the brain and nervous system cells rely on glucose for energy, and can only function when glucose levels in the blood remain within a certain range.


The body's use of glucose depends on the availability of insulin, a hormone produced by the pancreas. Insulin acts to control the transport of glucose into the body's cells to be used for energy. Insulin also directs the liver to store excess glucose as glycogen for short term energy storage and promotes the synthesis of fats, which form the basis of a longer-term store of energy. We cannot live without glucose or insulin, and they must be in balance.


Normally, blood glucose levels rise slightly after a meal, and insulin is released to lower them, with the amount of insulin released dependent upon the size and content of the meal. If blood glucose levels drop too low, such as might occur between meals or after a strenuous exercise, glucagon (another hormone from the pancreas) is produced to tell the liver to release some of its glucose stores, raising the blood glucose levels. If the glucose/insulin system is working properly the amount of glucose in the blood remains fairly stable.


Hyperglycaemia and hypoglycaemia, caused by a variety of conditions, are both hard on the body. Severe, sudden high or low blood glucose levels can be life-threatening, causing organ failure, brain damage, coma, and, in extreme cases, death. Long-term high blood glucose levels can cause progressive damage to body organs such as the kidneys, eyes, blood vessels, heart and nerves. Untreated hyperglycaemia that arises during pregnancy (known as 'gestational diabetes') can cause mothers to give birth to large babies who may have low glucose levels following birth. Long-term hypoglycaemia can lead to brain and nerve damage.

Methodology

We are using the FreeStyle Optium Blood Glucose Test Strips for testing your blood glucose via Abbott FreeStyle Optium Neo H blood glucose meter.

Preparation

In general, it is recommended that you fast (nothing to eat or drink except water) for at least 8 hours (generally 8-10 hours fast) before having a blood glucose test performed. For people with diabetes, glucose levels are often checked both while fasting and after meals to provide the best control of diabetes. For random, timed, and post-meal glucose tests, follow your healthcare professionals instructions.

Indications

Fasting blood glucose testing may be requested as part of a routine examination especially in those people at high risk of developing diabetes. The risk factors are:
  • Those with a strong family history of diabetes (first-degree relative)
  • Those who are overweight and obese
  • High-risk ethnicity/race (more prevalent among South Asian, Chinese, African-Caribbean and black African than white population)
  • People with other health conditions (those who have had myocardial infarction or a stroke, polycystic ovary syndrome (PCOS) or have a history of gestational diabetes)
  • People with mental health conditions or learning disabilities
  • People taking certain drugs such as steroids, anti-retroviral and some antipsychotic drugs
  • Previously impaired glucose tolerance, impaired fasting glucose or elevated HbA1c
There are different risk scores available to identify those at risk of developing diabetes. The fasting blood glucose test may also be used to help diagnose diabetes when someone has symptoms of hyperglycaemia such as:
  • Increased thirst
  • Increased urination
  • Urinary tract infections
  • Tiredness
  • Blurred vision
  • Slow-healing infections
Blood glucose may also be tested when a person has symptoms of hypoglycaemia, such as:
  • Sweating
  • Hunger
  • Trembling
  • Anxiety
  • Confusion
  • Blurred Vision
Glucose testing is also done in emergency settings to determine if low or high glucose is contributing to symptoms such as fainting and unconsciousness.

Interpretation

High levels of glucose most frequently indicate diabetes but many other diseases and conditions can also cause raised glucose concentrations in the bloodstream. The following information summarises the meaning of the test results.
Glucose Level Indication
Between 3.6 - 6.0 mmol/L Normal fasting glucose
Between 6.1 - 6.9 mmol/L Impaired fasting glucose
7.0 mmol/L and above Probable diabetes
Diagnosis of Gestational Diabetes (OGTT)
  • A fasting plasma glucose level of 5.6 mmol/L or above
  • A 2-hour plasma glucose level of 7.8 mmol/L or above
Some of the other diseases and conditions that can result in elevated glucose levels include:
  • Acromegaly
  • Acute stress (response to trauma, heart attack, and stroke for instance)
  • Long-term kidney disease
  • Cushing's syndrome
  • Drugs, including corticosteroids, tricyclic antidepressants, diuretics, adrenaline, oestrogens (birth control pills and hormone replacement therapy [HRT]), lithium, phenytoin (Dilantin), aspirin
  • Excessive food intake
  • Hyperthyroidism
  • Pancreatic cancer
  • Pancreatitis
Moderately increased levels may be seen with impaired glucose tolerance. This condition, if left unaddressed, can lead to type 2 diabetes. Low glucose levels (hypoglycaemia) are seen with:
  • Adrenal disease (Addison's disease)
  • Drinking alcohol
  • Drugs, such as paracetamol and anabolic steroids
  • Extensive liver disease
  • Hypopituitarism
  • Hypothyroidism
  • Insulin overdose
  • Overdose of glucose-lowering medications
  • Insulinomas (insulin-producing pancreatic tumours)
  • Starvation

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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