Carbohydrate Case Eight A 38 year old male previously diagnosed with diabetes me

Question

Carbohydrate Case Eight

A 38 year old male previously diagnosed with diabetes mellitus was seen by his HCP. His SMG fasting values were consistently, on average greater than120 mg/dL. He had not been feeling well for the past month.

The physician ordered a fasting glucose and A1c test to be performed. The results showed an A1c of <3.8% and a FBG of 302 mg/dL. The physician called the lab and asked about the discrepancy in the results.

Carbohydrate Case Studies

1. Is there a discrepancy in the results for the A1c and the fasting blood glucose?

2. Name 5 situations in which discrepant results for A1c and fasting blood glucose may be seen.

Explanation / Answer

The A1C test is a blood test to check a person's average levels of blood glucose over 3 months period it is also called haemoglobin A1C. This blood test result depicts Relative blood glucose level of past 3 months. It helps to understand the glucose level of all times during the past 3 months, while fasting , working , sleeping etc.It helps to modify the life style and re analyses the life style /food being followed .

But the momentary blood sugar test says the present glucose level of fasting or after food.

So there will be a change of values between the A1c blood test and the blood glucose level test (fasting/random)

Variation in glucose measurement can occur majorly is any one of the 3 conditions – biological variation, pre analytical and analytical conditions.

In biological – the glucose level can change in a same person at different time of the day, the blood test taken at different time of the fasting period shows different glucose level and it also vary from person to person.

Pre analytical – if patients are in any medications, or the blood sample taken from the peripheral where the intravenous fluid is administer influence the blood sugar level significantly .and when the blood sample is transferred to the laboratory for test/ duration of the sample taken and duration between the sample collection and the blood test actually done also influence the test results .

In analytical – different laboratories use different standardize tools , different calibrators and methods to titer the blood glucose value .

Any of the above conditions significantly shows the difference in blood glucose level

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