Sample type

Sample used : whole blood or serum (ie, plasma with removal of fibrinogen ).

-serum glucose levels is prefered in laboratories

 Because RBC have higher concentration of protein (eg, hemoglobin) than serum,
whereas serum has a higher water content and consequently more dissolved
glucose than does whole blood.

Arterial, capillary and venous blood have comparable glucose levels in a fasting
individual.

After meals venous levels are somewhat lower than capillary or arterial blood; a
common estimate is about 10%.

Measurement techniques

Two major methods have been used to measure glucose.

1.Chemical method

 In this method, chemicals are used as indicators.

This method is based on the reducing property of glucose. But there are other compounds
like urea that show the same reducing properties. That is reason why this method can be
erratic at times

2. Enzymatic methods ( use enzyme specific to glucose )

. The two most common employed enzymes are glucose oxidase and hexokinase..

I. CHEMICAL METHODS
A. Oxidation-Reduction Reaction

1. Alkaline Copper Reduction

Folin
Wu Blue end-product
Method
Benedict
's  Modification of Folin wu for Qualitative Urine Glucose
method
Nelson
Somogyi Blue end-product
Method
Neocupr
Yellow-orange
oine
* colorNeocuproine
Method
Shaeffer
 Uses the principle of Iodine reaction with Cuprous byproduct.
Hartma
nn  Excess I2 is then titrated with thiosulfate.
Somogyi
2. Alkaline Ferricyanide Reduction
Colorless end product;
Hagedor
other reducing substances
n Jensen
interfere with reaction
B. Condensation

Ortho-  Uses aromatic amines and hot acetic acid

toluidin
e  Forms Glycosylamine and Schiff's base which is emerald green in color
Method  This is the most specific method, but the reagent used is toxic
Anthron
e
(Phenols  Forms hydroxymethyl furfural in hot acetic acid
)
Method
II. ENZYMATIC METHODS
A. Glucose Oxidase

Saifer– Inhibited by reducing

Gerstenf substances like
eld BUA, Bilirubin,Glutathio
Method ne,Ascorbic Acid

 uses 4-aminophenazone oxidatively coupled with Phenol

Trinder  Subject to less interference by increases serum levels of Creatinine, Uric
Method
Acid or Hemoglobin
 Inhibited by Catalase

Kodak  A Dry Chemistry Method

Ektache  Uses Reflectance Spectrophotometry to measure the intensity of color through a lower
m
transparent film

Glucom  Home monitoring blood glucose assay method

eter
 Uses a strip impregnated with a Glucose Oxidase reagent
B. Hexokinase

 NADP as cofactor
 NADPH (reduced product) is measured in 340 nm
 More specific than Glucose Oxidase method due to G-6PO_4, which inhibits interfering substances
except when sample is hemolyzed

Blood glucose laboratory tests

1. fasting blood sugar (ie, glucose) test (FBS)

Fasting Blood Glucose

GLUCOSE LEVEL INDICATION

From 70 to 99 mg/dL (3.9 to 5.5 mmol/L) Normal fasting glucose

From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) Impaired fasting glucose (pre-diabetes) 

126 mg/dL (7.0 mmol/L) and above on more than one testing Diabetes 
occasion

2. urine glucose test

3. two-hr postprandial blood sugar test (2-h PPBS)
4. oral glucose tolerance test (OGTT)-

oral glucose tolerance test (OGTT) measures blood glucose after a person fasts at
least 8 hours and 2 hours after the person drinks a glucose-containing beverage. This
test can be used to diagnose diabetes and pre-diabetes.

5. intravenous glucose tolerance test (IVGTT)

6. glycosylated hemoglobin (HbA1C)
7. self-monitoring of glucose level via patient testing

Influences on blood glucose level

1. food intake.
2. Infection
3. Stress; physical or psychological.
4. Exercise