Protocol - Fasting Plasma Glucose - Blood Draw

The following is a summary version of the full National Health and Nutrition Examination Survey 2007-2008 protocol.

The full National Health and Nutrition Examination Survey 2007-2008 Fasting Plasma Glucose Test Procedures are part of the Oral Glucose Tolerance Test Procedure and can be found here: 2007-2008 NHANES Oral Glucose Tolerance Test Manual.

Exclusion Criteria:

Persons will be excluded from this component if they:

• Report that they are taking oral medications for diabetes;

• Report that they are taking insulin;

• Report that they are pregnant;

• Report that they have hemophilia;

• Report that they have received cancer chemotherapy in the last 3 weeks; and

• Report that they have not fasted at least 9 hours.

SP = Sample Person.

1. Did you eat or drink anything other than plain water after [Insert time at 9 hours prior to sample collection] last night?

[ ] Yes

[ ] No

[ ] Refused

[ ] Don’t Know

If answer is "No," then he or she has met the 9-hour fast. If answer is "Yes," "Don’t know," or "Refused," then the actual fasting time is unknown.

Confirmation Question:

2. Have you had any of the following since {insert time from 1 here}?

Coffee or tea with cream and sugar? [Include milk or non-dairy creamers.]

[ ] Yes If Yes, record time and date _____________

[ ] No

Alcohol, such as beer, wine, or liquor?

[ ] Yes If Yes, record time and date _____________

[ ] No

Gum, breath mints, lozenges, or cough drops, or other cough or cold remedies?

[ ] Yes If Yes, record time and date _____________

[ ] No

Antacids, laxatives, or anti-diarrheals?

[ ] Yes If Yes, record time and date _____________

[ ] No

Dietary Supplements such as vitamins and minerals? [Include multivitamins and single nutrient supplements.]

[ ] Yes If Yes, record time and date _____________

[ ] No

3. Are you currently pregnant?

1 [ ] Yes

2 [ ] No

3 [ ] Don’t Know

If answer is "Yes," then the SP is blocked from the Fasting Plasma Glucose test. If answer is "No" or "Don’t Know," the SP completes Fasting Plasma Glucose test.

4. {Is SP/Are you} now taking insulin?

1 [ ] Yes

2 [ ] No

7 [ ] Refused

9 [ ] Don’t Know

If the SP answers, "Yes," the SP is excluded from the Fasting Plasma Glucose test. If answer is "No" or "Don’t Know," the SP completes Fasting Plasma Glucose test.

5. {Is SP/Are you} now taking diabetic pills to lower {{his/her}/your} blood sugar? These are sometimes called oral agents or oral hypoglycemic agents

1 [ ] Yes

2 [ ] No

7 [ ] Refused

9 [ ] Don’t Know

If the SP answers, "Yes," the SP is excluded from the Fasting Plasma Glucose test. If SP answer "No" or "Don’t Know," the SP completes Fasting Plasma Glucose test.

6. Do you have hemophilia? (exclusion from Phlebotomy)

1 [ ] Yes

2 [ ] No

7 [ ] Refused

9 [ ] Don’t Know

If the SP answers, "Yes," the SP is excluded from the Fasting Plasma Glucose test. If SP answer "No" or "Don’t Know," the SP completes Fasting Plasma Glucose test.

7. Have you received cancer chemotherapy in the past four weeks or do you anticipate such therapy in the next 4 weeks? (exclusion from Phlebotomy)

1 [ ] Yes

2 [ ] No

7 [ ] Refused

9 [ ] Don’t Know

If the SP answers, "Yes," the SP is excluded from the Fasting Plasma Glucose test. If SP answer "No" or "Don’t Know," the SP completes Fasting Plasma Glucose test.

Venipuncture

Venipuncture should generally be performed using the median cubital, cephalic, or basilic veins in the left arm unless this arm is unsuitable. If the veins in the left arm are unsuitable, look for suitable veins on the right arm. If the veins in the antecubital space on both arms are not suitable, then look for veins in the forearm or dorsal side of the hand on the left arm/hand and then the right arm/hand.

Editor’s Note: Please review chapter 4 of the Laboratory Procedures Manual from the National Health and Nutrition Examination Survey 2007-2008 for a full description of Phlebotomy procedures: 2007-2008 NHANES Lab Manual.

Recording the Results of the Venipuncture Procedure

Immediately after completing the venipuncture, record the results of the blood draw, the reasons for a tube not being drawn according to the protocol, and any comments about the venipuncture.

Process the Sample for the Fasting Plasma Glucose Test

Editor’s Note: Please review chapter 8 of the Laboratory Procedures Manual from the National Health and Nutrition Examination Survey 2007-2008 for a full description of Blood Processing procedures: 2007-2008 NHANES Lab Manual.

Centrifuge and separate the plasma from the 10 mL tube as soon as possible. Process the specimen even if the contents of the tube clot.

• Separate the plasma by centrifugation.

• Use a calibrated plastic transfer pipette to transfer at least 0.5 mL plasma.

• Determine if the plasma is hemolyzed, turbid, lipemic, or icteric. If so, enter a comment to describe the plasma.

• Close all vessels secured to prevent leakage and evaporation.

Lab Assay for Fasting Plasma Glucose

The Diabetes Working Group recommends that glucose concentration be determined according to a hexokinase-mediated reaction such as the one developed by the University of Minnesota for use in the National Health and Nutrition Examination Survey: 2007-2008 NHANES Fasting Glucose Lab Assay.

Reference Ranges:

Fasting plasma glucose concentration normally ranges between 60-100 mg/dL Non-fasting glucose concentration normally ranges between 60-139 mg/dL