Glucose, Random

CPT CODE:

USEFUL FOR:

Diagnosing and managing diabetes mellitus and other carbohydrate metabolism disorders including gestational diabetes, neonatal hypoglycemia, idiopathic hypoglycemia, and pancreatic islet cell carcinoma.

SPECIMEN REQUIRED:

Submit only 1 of the following specimens (serum preferred):
SerumDraw blood in a plain, red-top tube(s) or a serum gel tube(s).Spin down and send 1.0 mL of serum refrigerated.Note:    1. Indicate serum on request form.                2. Label specimen appropriately (serum).
PlasmaDraw blood in a grey-top (potassium oxalate/sodium fluoride) tube(s).Spin down and send 1.0 mL of potassium oxalate/sodium fluoriderefrigerated.Note:    1. Indicate plasma on request form.                2. Label specimen appropriately (plasma).

TRANSPORT TEMPERATURE:

Refrig\Frozen OK\Ambient NO

CLINICAL INFORMATION:

The most common disease related to carbohydrate metabolism is diabetes mellitus which is characterized by insufficient blood levels of active insulin. Symptoms include polyuria, abnormally elevated blood and urine glucose values, excessive thirst, constant hunger, sudden weight loss, and possibly elevated blood and urine ketones. Complications from diabetes are the third leading cause of death in the United States. There are approximately 16 million diabetics in the United States, and that number is growing. It is estimated that at least 5 million of these people have not been diagnosed. The prevalence in the population age 65 and older is 18.4%, representing 6.3 million cases. The cost of diabetes to the US economy exceeds $92 billion annually.
Overproduction or excess administration of insulin causes a decrease in blood glucose to levels below normal. In severe cases, the resulting extreme hypoglycemia is followed by muscular spasm and loss of consciousness, known as insulin shock.

CLINICAL INTERPRETATION:

Any of the following results, confirmed on a subsequent day, can beconsidered diagnostic for diabetes: -a fasting plasma or serum glucose > or = 126 mg/dL after an 8-hour fast; -2-hour plasma or serum glucose > or = 200 mg/ dL during a 75-gram oral  glucose tolerance test (OGTT); -random glucose >200 mg/dL, plus typical symptoms.
Patients with "impaired" glucose regulation are those whose fasting serum or plasma glucose fall between 101 and 126 mg/dL, or whose 2-hour value on OGTT fall between 140 and 199 mg/dL. These patients have a markedly increased risk of developing type 2 diabetes and should be counseled for lifestyle changes and followed up with more testing.  Indications for screening and testing include strong family history, marked obesity, history of babies over 9 pounds, and recurrent skin and genitourinary infections.
Glucose levels < or =25 mg/dL in infants <1 week are considered to be potentially life threatening; as are glucose levels < or =40 mg/dL in infants >1 week.
Glucose levels > or =400 mg/dL are considered a critical value.

REFERENCE VALUES:

0-11 months: not established

> or = 1 yr:  70-100 mg/dL