Diabetes Mellitus:  Lipids

 

Nuts and Bolts of Testing

There are just a few specific items that important to keep in mind when you try and interpret your patient's glucose numbers.

  1. Laboratory glucose values report plasma glucose levels.  Most newer glucose meters also give the level of plasma glucose.  Older meters (such as the one touch basic) measure and report whole blood glucose levels.  Recall that whole blood glucose levels are about 12% lower than plasma glucose levels.
  2. Glucose meter results have about a 10% variation.  Thus you and your patients may be frustrated when comparing results from one meter to the next (especially if one meter is measuring whole blood, and the other plasma.)
 
 
  1. When alternative site (forearm) meters are used, there may be false results during times of rapid glucose flux.  Specifically, the values may be suspect during hypoglycemic episodes and postprandially.  Thus, the fingertip should be used during those times.
  2. Finally, false low finger tip glucose levels have been reported in vasoconstricted patients (Rushakoff RJ, Lewis SB:  Case of Pseudohypoglycemia.  Diabetes Care 2001 24: 2157-2158and hypotensive volume depleted patients (Atkin SH, Dasmahapatra A, Jaker MA, Chorost MI, Reddy S: Fingersick glucose determination in shock. Ann Intern Med 114:10201024, 1991)