A Problematic Case Due to Blood Collection for Fasting Plasma Glucose Assessment. , Vol. 7, No. 3, SEMJ

In the name of God

Department of Internal Medicine
Shiraz E-Medical Journal
Vol. 7, No. 3, July 2006

A Problematic Case Due to Blood Collection for Fasting Plasma Glucose Assessment.

Wiwanitkit V.

Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330 Thailand; Physician at Health Unit, Student Affairs, Chulalongkorn University Bangkok 10330 Thailand.

Correspondence: Viroj Wiwanitkit, Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok Thailand 10330, Tel: (662) 256-4136, Email:wviroj@yahoo.com

Received for Publication: April 3, 2006, Accepted for Publication: July 17, 2006.

Abstract:

Fasting plasma glucose (FPG) is useful for routine following up of the diabetic patients. Here, the author reported an interesting mortal case due to the fasting plasma glucose blood collection. In this case, it can be a good case study on the complication of fasting procedure for blood collection of FPG determination. However, the precautions for the diabetic patients whose the history of blood glucose control is fluctuated should be specially set.

Key Words: Fasting, Plasma Glucose.

Introduction:

The benefits of screening for type 2 diabetes during its preclinical phase are well established in comparison to starting a treatment after a diagnosis is made when the patient presents with symptoms of hyperglycemia. Among the different screening tests, measurement of fasting plasma glucose (FPG) is the first choice ⁽¹⁾. The FPG is also useful for routine following up of the patients.

FPG is a basic blood test for all hospitals. A number of FPG tests are requests to each medical laboratory everyday. For quality control, the standard process for specimen collection including to the determination of fasting condition of the patients is necessary. Here, the author reported an interesting mortal case due to the fasting plasma glucose blood collection.

Case Report

An emergency call for help was set from the venipuncture clinic because the phlebotomist detected that the patient on the wheelchair was arrested. This case was delivered to the emergency room but the resuscitation was failed. From the history review, this case was a known case of diabetic patient waiting for the FPG determination at the venipuncture clinic in the morning. The patient regularly got the oral diabetic drug. The glucose of the collected blood sample of this case was equal to 0 mg/dL. The cause of death is believed to due to hypoglycemia.

Discussion:

Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both ⁽²⁾. The number of cases of diabetes mellitus is estimated to grow at a rate of 50% between 2000 and 2010 ⁽³⁾.The diagnosis of diabetes is usually based on the evaluation of glucose plasma levels performed under fasting condition.
In this case, it can be a good case study on the complication of fasting procedure for blood collection of FPG determination. Indeed, at least 8 hours fasting period is recommended for all FPG determination. However, the precautions for the diabetic patients whose the history of blood glucose control is fluctuated should be specially set. Regarding this patient, unfortunately, no history is available about the duration of fasting.

References:

1. Taminato T. Fasting plasma glucose for diagnosis of diabetes mellitus. Nippon Rinsho. 2005;63 Suppl 2:376-81

2. Barr RG, Nathan DM, Meigs JB, Singer DE. Tests of glycemia for the diagnosis of type 2 diabetes mellitus. Ann Intern Med. 2002;137:263-72

3. Bosi E. Diabetes mellitus. G Ital Nefrol. 2003;20 Suppl 25:S3-6.

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Copyright © 2006 by Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. All rights reserved.