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Fasting Blood Glucose Test

A primer on what it's used for and how it's done

The fasting blood glucose test is the test most commonly used to diagnose diabetes. It measures blood glucose levels
after a period of fasting, usually at least eight hours without food or liquid (except water). This test is more
definitive than a random test, because there is no chance that it has been influenced by recent food intake.
If your fasting blood glucose level is greater than 125 mg/dL in two separate tests, then the diagnosis of diabetes is
What it's used for
This test is used to measure your level of fasting blood glucose to diagnose diabetes.
Don't eat or drink anything but water for eight hours before the test is scheduled. Most of the time, this means
having the test done in the morning, before breakfast.
How it's done
A small amount of blood is collected either from a finger or from a vein. The blood is then analyzed and you will be
informed of the results.
If the first level is above 125 mg/dL, the fasting blood glucose test will be done again (for example, the next day) to
confirm a diagnosis of diabetes. A value between 100 and 125 mg/dL indicates pre-diabetes. Someone with a result
in this range should be followed closely, with follow-up testing.
There are no risks to this test.
Call your doctor if you have any questions about what the test means.
Additional information
Fasting blood glucose less than 100 mg/dL is normal.

Food and Blood Glucose Levels

Once you understand how your body reacts to food, you can make better choices to help you manage your
The food you eat directly impacts blood glucose levels. In order to create a meal plan that works best for youone
that helps you stay within your target range and eat the foods you likeyou should be aware of how the foods you
eat change your blood glucose level. Keep in mind:

Carbohydrates: Be aware of how many carbs you are eating (the food label can help)

Portion size: How much of an item you eat (serving or portion size) can make a difference in how many
calories, carbohydrates and other nutrients you intake. For example, one serving of apple may not raise your blood
glucose too high, but two servings of apple might be more than your limit of carbohydrates.

Time of day: When you eat also impacts how your blood glucose responds. You may find it helpful to eat
meals and snacks at close to the same time each day (and eat foods with similar amounts of nutrients), as a strategy
to help your blood glucose stay in range.

Beverages: Don't forget to include any juice, soda, alcoholic beverage or milk in your total
calorie/carbohydrate count, and be aware that beverages can impact your blood glucose just like food.

Snacks: Whether it's a handful of grapes, nuts or a cookie, don't forget to keep track of your snacks during
the day, so you'll knowif you're testingif those foods increase your blood glucose levels, too.
Monitoring means information
One way to get immediate feedback on the impact of food is to monitor your blood glucose. How often you test will
depend on:

The schedule you've set with your health care team

Your level of control

Your medication (or therapy type)

How much your blood glucose fluctuates during the day.

Blood glucose testing around meals and snacks can give you and your health care team information to keep your
blood glucose levels in range, and help you feel your best.

Before a meal: Testing before each meal can help you decide what and how much to eat and, in some
cases, how to adjust your medication. A typical blood glucose level target before a meal is 110 mg/dL.

Two hours after a meal: By monitoring your blood glucose to see the impact of what you ate on your
blood glucose, test two hours after you start your meal. The results will help you know whether what you ate had too
many carbs and if you should eat less or eat differently the next time. Two hours after a meal, a typical target blood
glucose level is below 140 mg/dL.
What are some ways you might use monitoring?
Be sure to discuss patterns with your health care team and explore opportunities for improving your blood glucose
control. For example, if your blood glucose is highest after breakfast, consider testing before and after breakfast
until you and your doctor come up with satisfying menu options that don't raise your blood glucose. Once you've
mastered breakfast, reduce testing around that meal, and focus on another time of day (or event) you may find
challenging. Or if you are trying a new food, consider testing before and two hours after eating to determine whether
to add the item to your meal plan.

Blood Glucose Monitoring

Blood glucose monitoring is a way of testing the concentration of glucose in the blood
(glycemia). Particularly important in the care of diabetes mellitus, a blood glucose test is performed by
piercing the skin (typically, on the finger) to draw blood, then applying the blood to a chemically active
disposable 'test-strip'. Different manufacturers use different technology, but most systems measure an
electrical characteristic, and use this to determine the glucose level in the blood. The test is usually
referred to as capillary blood glucose and sometimes incorrectly called BM Stix (after one of the
companies that makes the test kit).
Healthcare professionals advise patients with diabetes on the appropriate monitoring regime for their
condition. Most people with Type 2 diabetes test at least once per day. Diabetics who use insulin (all Type
1 diabetes and many Type 2s) usually test their blood sugar more often (3 to 10 times per day), both to
assess the effectiveness of their prior insulin dose and to help determine their next insulin dose.
Improved technology for measuring blood glucose is rapidly changing the standards of care for all
diabetic people.

Blood glucose monitoring reveals individual patterns of blood glucose changes, and helps in the planning
of meals, activities, and at what time of day to take medications.

Also, testing allows for quick response to high blood sugar (hyperglycemia) or low blood sugar
(hypoglycemia). This might include diet adjustments, exercise, and insulin (as instructed by the health
care provider).[1]

A blood glucose meter is an electronic device for measuring the blood glucose level. A relatively small
drop of blood is placed on a disposable test strip which interfaces with a digital meter. Within several
seconds, the level of blood glucose will be shown on the digital display.
Needing only a small drop of blood for the meter means that the time and effort required for testing is
reduced and the compliance of diabetic people to their testing regimens is improved. Although the cost of
using blood glucose meters seems high, it is believed to be a cost benefit relative to the avoided medical
costs of the complications of diabetes.
Recent advances include:

alternate site testing', the use of blood drops from places other than the finger, usually the palm or
forearm. This alternate site testing uses the same test strips and meter, is practically pain free, and
gives the real estate on the finger tips a needed break if they become sore. The disadvantage of this
technique is that there is usually less blood flow to alternate sites, which prevents the reading from
being accurate when the blood sugar level is changing.

no coding' systems. Older systems required 'coding' of the strips to the meter. This carried a risk
of 'miscoding', which can lead to inaccurate results. Two approaches have resulted in systems that no
longer require coding. Some systems are 'autocoded', where technology is used to code each strip to
the meter. And some are manufactured to a 'single code', thereby avoiding the risk of miscoding.

multi-test' systems. Some systems use a cartridge or a disc containing multiple test strips. This
has the advantage that the user doesn't have to load individual strips each time, which is convenient
and can enable quicker testing.

downloadable' meters. Most newer systems come with software that allows the user to download
meter results to a computer. This information can then be used, together with health care professional
guidance, to enhance and improve diabetes management. The meters usually require a connection
cable, unless they are designed to work wirelessly with an insulin pump, or are designed to plug
directly into the computer.

A continuous glucose monitor (CGM) determines glucose levels on a continuous basis (every few
minutes). A typical system consists of:

a disposable glucose sensor placed just under the skin, which is worn for a few days until

a link from the sensor to a non-implanted transmitter which communicates to a radio receiver

an electronic receiver worn like a pager (or insulin pump) that displays glucose levels with nearly
continuous updates, as well as monitors rising and falling trends.

Continuous glucose monitors measure the glucose level of interstitial fluid. Shortcomings of CGM
systems due to this fact are:

continuous systems must be calibrated with a traditional blood glucose measurement (using
current technology) and therefore require both the CGM system and occasional "fingerstick"

glucose levels in interstitial fluid lag behind blood glucose values

Patients therefore require traditional fingerstick measurements for calibration (typically twice per day)
and are often advised to use fingerstick measurements to confirm hypo- or hyperglycemia before taking
corrective action.
The lag time discussed above has been reported to be about 5 minutes. Anecdotally, some users of the
various systems report lag times of up to 1015 minutes. This lag time is insignificant when blood sugar
levels are relatively consistent. However, blood sugar levels, when changing rapidly, may read in the
normal range on a CGM system while in reality the patient is already experiencing symptoms of an outof-range blood glucose value and may require treatment. Patients using CGM are therefore advised to
consider both the absolute value of the blood glucose level given by the system as well as any trend in the
blood glucose levels. For example, a patient using CGM with a blood glucose of 100 mg/dl on their CGM
system might take no action if their blood glucose has been consistent for several readings, while a patient
with the same blood glucose level but whose blood glucose has been dropping steeply in a short period of
time might be advised to perform a fingerstick test to check for hypoglycemia.
Continuous monitoring allows examination of how the blood glucose level reacts to insulin, exercise,
food, and other factors. The additional data can be useful for setting correct insulin dosing ratios for food
intake and correction of hyperglycemia. Monitoring during periods when blood glucose levels are not
typically checked (e.g. overnight) can help to identify problems in insulin dosing (such as basal levels for
insulin pump users or long-acting insulin levels for patients taking injections). Monitors may also be
equipped with alarms to alert patients of hyperglycemia or hypoglycemia so that a patient can take
corrective action(s) (after fingerstick testing, if necessary) even in cases where they do not feel symptoms
of either condition. While the technology has its limitations, studies have demonstrated that patients with
continuous sensors experience less hyperglycemia and also reduce their glycosylated hemoglobin levels.

Currently, continuous blood glucose monitoring is not automatically covered by health insurance in the
United States in the same way that most other diabetic supplies are covered (e.g. standard glucose testing
supplies, insulin, and even insulin pumps). However, an increasing number of insurance companies do
cover continuous glucose monitoring supplies (both the receiver and disposable sensors) on a case-bycase basis if the patient and doctor show a specific need. The lack of insurance coverage is exacerbated by
the fact that disposable sensors must be frequently replaced. Some sensors have been U.S. Food and Drug
Administration (FDA) approved for 7- and 3-day use, though some patients wear sensors for longer than
the recommended period) and the receiving meters likewise have finite lifetimes (less than 2 years and as
little as 6 months). This is one factor in the slow uptake in the use of sensors that have been marketed in
the United States.

Investigations on the use of test strips have shown that the required self-injury acts as a psychological
barrier restraining the patients from sufficient glucose control. Secondary diseases are accordingly put up
with too high glucose levels. A significant improvement of diabetes therapy might be achieved with an
implantable sensor that would continuously monitor blood sugar levels within the body and transmit the
measured data outside. Longer term solutions to continuous monitoring, not yet available but under
development, use a long-lasting bio-implant. The burden of regular blood testing would be taken from the
patient, who may instead follow the course of their glucose levels on an intelligent device like a laptop or
a smart phone.
Glucose concentrations do not necessarily have to be measured in blood vessels, but may also be
determined in the interstitial fluid, where the same levels prevail with a time lag of a few minutes due
to its connection with the capillary system. However, the enzymatic glucose detection scheme used in
single-use test strips could not be shown so far to be suitable for implantsalso. One main problem is
caused by the varying supply of oxygen, by which glucose is converted to glucono lactone and
H2O2 by glucose oxidase. Since the insertion of a technical device like a sensor into the body is always
accompanied by a steadily growing encapsulation tissue the diffusion of oxygen to the reaction zone is
continuously diminished. The decreasing oxygen availability causes the sensor to drift and enzymatic
glucose sensors have thus always shown an artificial drift of the data.
An important progress has recently been achieved with an implantable sensor measuring not glucose
alone, but also the concentration and corrected the first signal with the latter. In another approach glucose
is not converted in a chemical reaction, but only reversibly bound to a chemical receptor and which is
denoted an affinity assay. The scheme has been put forward by Schultz & Sims in 1978. Different
technical variants of the assay were investigated so far with fluorescent glucose biosensor representing
the dominating detection scheme.Investigation of affinity-based sensors have shown that the
encapsulation by body tissue does not cause a drift of the sensor signal, but only a time lag of the signal
compared to the direct measurement in blood.

In 2013 a microelectronic sensor chip was presented, by which glucose concentrations are determined
from the viscosity of a sensoric liquid. The viscosity is modulated by glucose through the binding
to concanavalin A, which competes with that to a natural glucose polymer being dextran. The chip is
fabricated as a microelectromechanical system (MEMS) from a combinedCMOS/BiCMOS technology.
Viscosity is determined from the velocity of 50 nm thin beam of titanium nitride that is bent in a quasielectrostatic mode. Its movement through the sensoric liquid is fast or slow depending on glucose level.
The sensor chip is extremely miniaturized and thus offers the perspective for a convenient implantable
glucose monitor.

1.) Mr.Patient X 44 years old was a diabetic patient which of the following instrument will he use to
measure his glucose level that can be easily be teach to the client as a nurse what will you teach to the

a. CBG
2.What type of test is used in diagnosing diabetic patients ?

3. FBG is more accurate when?

a. not yet been eating
b. when eaten
c. before going to bed
d. none of the above
4. What type of test is usually been done in monitoring Glucose Concentration in the blood?
a. FBG
b. CBG
c. UA
d. None of this
5. When you are doing Complete Blood Glucose Test the nurse should?
a. assest the patient
b. check the bed tags
c. Check patients id tag
d. Proceed to the procedure
6. What instrument is used in determining the level in continous basis
a. CGM
7. After you done the procedure you notice that the blood glucose level of the patient is high what you
should do?
a. notice the physician
b.inject insulin via (tuberculine syringe)
c. Ignore the patient
8. When you notice that the patient is eating and it has a schedule of CBG monitoring what is the first
thing you do?
a. do the procedure anyway
b.put on the note that the client is eaten when doing the procedure
c.wait for two to three hours and do the procedure
d.None of this
9.Is CBG test is can be used even if you are not a nurse?
10.CBG can detect if you are?
a.low blood glucose level
b.high blood glucose level
c.both a and b
d.none of this

1. B. FBG
It is the test usually been done in diabetic patients

2. A FBG
It is the test usuallybeen done in diabetic patients
3. A not yet been eaten
because you have not eaten that is the good way in doing FBG test
4. B. CBG

this is usually been done in monitoring Glucose Level

5. C. check i.d tag
You should check the i.d tag of the patient if she is the right client who will undergone this type of test

6.A. CGM(Continous Glucose Monitoring)

this is the test that was been done in monitoring continuously the concentration of glucose level
7.B. inject insulin (tuberculin syringe)
this is independent nursing procedure so that the glucose level of the client will decreased
8. C.wait two to three hours and do th procedure
To make sure that the food that was eaten is digested before doing the procedure
9.A yes
Even the people that can afford to buy this instrument can do this dependently on their own
10. C. Both a and b
CBG monitoring can detect if you are low glucose level or high glucose level in your body