I picked up this thread a little late. Sorry to be pedantic. You aren't
actually saying it, Phil, but from the last few messages I get the
implication that a random glucose > 11 mmol/L warrants a comment that the
patient is diabetic (with the proviso of needing a second abnormal sample).
Am I missing some more recent guideline than Varley that says that?
What if the 'random' sample were taken at a post prandial peak e.g. 0.5-1.5
hrs after a meal? Presumably a 2 hr GTT glucose could have fallen to <11.1
mmol/L i.e. not diabetic according to WHO.
Is WHO out of line with Varley?
It's very unlikely as no GP would be silly enough to take a sample just
after a big meal. Or would they...?
Steve
-----Original Message-----
From: Wills Philip (Queen Elizabeth Hospital NHS Trust)
[mailto:[log in to unmask]]
Sent: 05 January 2005 10:26
To: [log in to unmask]
Subject: Random Plasma Glucoses
Thanks for the many replies so far and in
general,laboratories quote (as we do)11.1mmol/L as the upper
limit of "normal" for a random plasma glucose.Unless I am
mistaken,this goes back to the dark days of GTTs in Varley
1st edition etc when 200mg/dL was the "normal" maximum (?
whole blood) glucose level 30 minutes post glucose
load.Therefore a "normal" person is "allowed" to have a
random glucose value up to this level and of course 200mg/dL
equates to 11.1 mmol/L,
How many people have meals at any time equivalent to 75g
glucose and how many of you out there would like at any time
to have a plasma glucose of 9.1mmol/L let alone 11.1 mmol/L.
I understand the sentiments in Jonathan's e-mail but if we
cannot know what question is being asked,how can we know what
answer to give?
With regard to Richard's comments.I am not sure if it is
exactly the same problem as in the GTT thread before
Christmas.He says results should reflect disease but if we
tell GPs that its "normal" to have a random glucose up to
11.1 mmol/L then its not reflecting anything.
Phil
***************************************************************************
This e-mail is confidential and privileged. If you are not the intended
recipient please accept our apologies; please do not disclose, copy or
distribute information in this e-mail or take any action in reliance on its
contents: to do so is strictly prohibited and may be unlawful. Please
inform us that this message has gone astray before deleting it. Thank you
for your co-operation.
***************************************************************************
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
This electronic message contains information from Brighton and Sussex University Hospitals NHS Trust, which may be privileged or confidential. The information is intended to be for the use of the individual(s) or entity named above. If you are not the intended recipient be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic message in error, please notify us immediately at [log in to unmask]
Activity and use of the Brighton and Sussex University Hospitals NHS Trust E-mail system is monitored to secure its effective operation and for other lawful business purposes. Communications using this system will also be monitored for viruses and other harmful material.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|