Activity 1

CLINICAL CHEMISTRY ANALYZERS

STUDENT JOB SHEET: LEARNER’S NOTES

Name: Ricah Mae O. Borral Date: June 18, 2023

INSTRUCTION: Search from PRINTED OR ONLINE, OR VIDEO RECORDED valid references

information that would help in the achievement of the following learning outcomes. Follow this
template (cut this page or copy paste) for your answers and submit it according to the instruction of
your instructor. Use additional page if needed. PLEASE INDICATE THE SOURCE/S OF YOUR
ANSWERS.

LEARNING OUTCOMES ANSWERS

Discuss the different types of 1. Photometric

laboratory measurement  Photometry is the measuring of light absorbed in wavelengths
technologies in clinical ranging from ultraviolet (UV) to visible (VIS) to infrared (IR). This
chemistry. measurement is used to calculate the concentration of an
analyte in a solution or liquid. Photometers make use of a
specific light source and detectors to transform light that has
passed through a sample solution into a proportional electric
signal. These detectors could be photodiodes, photoresistors, or
photomultipliers, for example. Beer-Lambert's law is used in
photometry to calculate coefficients derived from transmittance
measurements. A test-specific calibration function then
establishes a link between absorbance and analyte
concentration to provide highly precise readings.
 Photometry is a quantitative study that is commonly used in
research laboratories to determine the levels of inorganic and
organic chemicals in solutions and other liquids. Photometry has
numerous industrial uses, including the detection of pollutants in
drinking water and wastewater, the measurement of nutrients in
soil, food and beverage samples, building material composition,
and many others.
2. Colorimetric
 Colorimetric tests employ a colorimeter (spectrophotometer) to
estimate the quantity of a chemical compound in a solution by
measuring the molecule's spectral absorbance at a certain
wavelength. During the reaction of a detecting chemical with the
target substance, a color is generated. The intensity of the color,
as assessed by a spectrophotometer, is an indicative of the
amount of the target ingredient. Colorimetric techniques are
frequently used for protein analysis. Colorimetric assays are not
particularly sensitive and are easily impacted by pH and
temperature of a solution, despite being simple, fast, and
inexpensive.
3. Ion selective potentiometry
 Ion-selective electrodes (ISEs) are potentiometric sensors with a
selective membrane to reduce matrix interferences. The pH
electrode is the most common ISE, and it consists of a thin glass
membrane that responds to the concentration of H+ in a
solution. Other factors that can be measured include fluoride,
4
 bromide, nitrate, and cadmium, as well as gases in solution such
as ammonia, carbon dioxide, nitrogen oxide, and oxygen. ISEs
have limitations, such as a lack of selectivity and sensitivity, as
well as issues with electrode training
 Ion-selective electrodes are one of the most commonly utilized
potentiometric sensors in laboratory analysis. The key
advantage over spectroscopic approaches is that most
spectroscopic techniques are extremely expensive and require
extensive infrastructure backup and specialist support. Ion
sensors, on the other hand, provide analytic processes that
address the above disadvantages because they are rapid and
require minimal sample preparation. The ionophore is the
primary factor in the sensitivity and selectivity of ion-selective
electrodes. An excellent ionophore has a stronger affinity for one
ionic species than others.
4. Latex agglutination
 Latex agglutination is a variation on the clumping ability seen
when a sample containing the specific antigen is combined with
an antibody coated on the surface of latex particles. The
agglutination response can be reversed by coating a specific
antigen on a latex particle and analyzing a sample for the
presence of specific antibodies. Synthetic beads provide
consistency, uniformity, and stability. Furthermore, the latex
agglutination assay has a quick advantage for determining
results, which are frequently obtained within minutes. Other
benefits of employing synthetic beads are their versatility
(enabling the binding of chemically complex antigens), simplicity
of design, ease of performance, and ability to operate with small
amounts of sample. Finally, this form of reaction does not, by
definition, necessitate the use of expensive equipment for
sample analysis. A word of caution: contaminations in sample
preparations can cause interference and false negatives.

Source:
LabbCompare (n.d.). Clinical Chemistry Analyzers.
https://www.labcompare.com/Pharmaceutical-Lab-Equipment/879-Chemistry-
Analyzer-Clinical-Chemistry-
Analyzers/#:~:text=Clinical%20chemistry%20analyzers%2C%20also%20referred,seru
m%2C%20plasma%2C%20and%20urine.

Merck (n.d.). Photometry & Reflectometry.

https://www.sigmaaldrich.com/PH/en/applications/analytical-chemistry/photometry-
and-reflectometry

J.A. Cooper et. al. (2013). Assays for determining cell differentiation in biomaterials.
https://www.sciencedirect.com/topics/chemistry/colorimetry#:~:text=Colorimetric%20a
ssays%20use%20a%20colorimeter,chemical%20with%20the%20target%20substance

F. Martos, R. Rojas.(2016). Cobalt: Properties and Determiantion.

https://www.sciencedirect.com/topics/nursing-and-health-professions/ion-selective-
electrode

G. Hanrahan et. al. (2005). Water Analysis - Freshwater.

https://www.sciencedirect.com/topics/chemistry/ion-selective-electrode

Wanger A. et. al. (2017). Antigen and Antibody Testing.

https://www.sciencedirect.com/topics/medicine-and-dentistry/latex-agglutination-
test#:~:text=The%20latex%20agglutination%20reaction%20is,the%20surface%20of%
20latex%20particles.
Discuss the advantages and Manual laboratory testing is actually preferable when there are fewer
disadvantages of the manual specimens to test. It is useful for testing complex integration situations that
laboratory testing methods in cannot be automated otherwise. The best aspect of manual testing is that it
helps to detect visual faults that cannot be mechanized or identified by
clinical chemistry.
automation and for verification of suspicious results, since judgement and
rationalization can be done by the medical technologists.

However, we cannot dispute that laboratory automation overcomes the

drawbacks of manual testing. In compared to manual methods, there is an
increase in the number of tests done, a decrease in the labor component,
and the use of modest amounts of samples and reagents. Increasing
efficiency while cutting costs has been a primary motivator for laboratories
to begin incorporating some features of total laboratory automation into
their operations.
5
 Source:
Bishop, M. L., Fody, E. P., & Schoeff, L. E. (2018). Analytic Techniques. In Clinical
chemistry: Principles, techniques, and correlations (8th ed., pp. 308–358). essay,
Jones & Bartlett Learning.
State the advantages and
disadvantages of using Advantages Disadvantages
automated chemistry analyzers Faster specimen processing High initial costs
in the laboratory. Efficient handling of large number Greater supplies expenditures/cost
of samples
Better accuracy and precision of Greater expenditures for
results equipment maintenance
Allows performance of multiple Space requirements and
tests in a single equipment infrastructure constraints
Significantly reduced labor Increased risk of downtime
requirements
Allows standardization, improving
the quality of testing

Source:
Lippi G. and Rin G. (2019). Advantages and limitations of total laboratory automation:
a personal overview. https://pubmed.ncbi.nlm.nih.gov/30710480/
Dayyal (2018). Advantages and Disadvantages of Automated Hematology Analyzer.
https://www.bioscience.com.pk/topics/hemotology/item/810-advantages-and-
disadvantages-of-automated-hemotology-analyzer
Compare discrete and Discrete Analyzers use sample trays and discrete reaction wells to perform
continuous flow analysis the colorimetric reaction. Segmented flow analyzers, on the other hand,
systems. use a continuous flow of samples and reagents separated by air bubbles
within tubing and mixing coils. Discrete analyzers are useful when
automation is a requirement and/or when many and diverse analyses on
various samples are required. Discrete flow analysis systems handle
samples one at a time to enable flexibility in test selection and sample
management. They are suitable for a wide range of studies and need less
reagent volume. They are, however, less effective for high-throughput
testing and necessitate longer experiment times per sample. Continuous
flow analysis systems, on the other hand, analyze samples continuously,
resulting in better throughput and shorter test times. Although they require
more reagents and may have test selection constraints, they are ideal for
routine testing. Continuous Segmented Flow Analysis is appropriate for
analyzing a high number of samples for a small number of chemistries.
However, because both procedures are adaptable, it is critical to seek
expert help when selecting an analyzer and ensuring that the instrument is
configured to fit the particular demands of the laboratory.
Source:

Seal Analytical (2013). Is Discrete or Continous Flow Analysis Best. https://www.seal-

analytical.com/News/Is-Discrete-or-Continuous-Flow-Analysis-
Best#:~:text=In%20general%20terms%2C%20discrete%20analyzers,a%20smaller%2
0number%20of%20chemistries.
Explain the role of CLIA with When using chemical analyzers, laboratories must follow CLIA (Clinical
chemistry analyzers. Laboratory Improvement Amendments) rules, which require them to
develop quality control measures, participate in proficiency testing
programs, ensure that staff members are qualified and competent, undergo
compliance inspections, and keep accurate patient result records. CLIA's
goal is to ensure the accuracy, dependability, and quality of laboratory tests
performed with chemical analyzers in order to provide high-quality patient
care.
Source:
Center for Devices and Radiological Health & Center for Devices and Radiological
Health. (2021). Clinical Laboratory Improvement Amendments (CLIA). U.S. Food And
Drug Administration. https://www.fda.gov/medical-devices/ivd-regulatory-
assistance/clinical-laboratory-improvement-amendments-
clia#:~:text=The%20Clinical%20Laboratory%20Improvement%20Amendments,human
%20samples%20for%20diagnostic%20testing.

6
Relate what considerations Choosing the correct analyzer is critical to successful and safe laboratory
should be carried out when testing. The volume of testing, level of automation, and throughput capacity
selecting chemistry analyzer for should all be considered. Modular solutions can be easily scaled to meet
changing laboratory needs. Here are some pointers to help you select the
a laboratory.
best chemistry analyzer for your lab:
 Choose a brand with reputation
 Check load, capacity, ease of operation, durability, and price
 Ensure that the device can deliver accurate and consistent results in
quick turnaround time
 Ensure that design complies with industry rules and regulations
 Check technical specifications to make sure that the instrument can
meet your lab's specific requirements
 Check the safety features including closed tube sampling and
aliquoting
 Examine whether the product has facilities to execute STAT and
routine immunoassays simultaneously
 Check if the device has a built-in printer to print patient reports
 Analyze productivity, capacity and workflow competence
Source:
Block Scientific (2015). Choosing the Right Chemistry Analyzer.
https://www.blockscientific.com/choosing-right-chemistry-analyzer
Discuss the procedure in doing Select relevant QC materials and prepare them according to instructions
quality control run in chemistry before doing a quality control run on a chemical analyzer. Check that the
analyzer. instrument is properly calibrated and set up. Start the run with the QC
materials on the analyser. Using statistical methods for analysis, compare
the acquired results to predicted values or target ranges. If the results fall
outside of the acceptable range, investigate and take corrective action.
Document all QC run details and follow up as needed. Repeat the QC run
on a regular basis in accordance with the quality control schedule
established by the laboratory.
Source:
Labpedia (2023). Quality Control (QC) of the Clinical Laboratory.
https://labpedia.net/quality-control-of-the-clinical-laboratory/

7
 ON THE JOB TASK SHEET: COGNITIVE APPLICATION

Name: Ricah Mae O. Borral Date: June 18, 2023

INSTRUCTION: Search from PRINTED OR ONLINE, OR VIDEO RECORDED valid references

information that would help in the achievement of the following learning outcomes. Follow this
template (cut this page or copy paste) for your answers and submit it according to the instruction
of your instructor. Use additional page if needed. PLEASE INDICATE THE SOURCE/S OF YOUR
ANSWERS.

ON-THE-JOB TASKS ANSWERS

Jane is a Senior Medical Personally, I would choose a continuous flow analyzer because of its high
Technologist in a Chemistry throughput, capacity to manage big workloads, and shorter assay periods.
Section. Her supervisor asked Continuous flow analyzers offer established methods, built-in quality
control tools, and seamless workflow and information system integration.
her to help her decide on what
These advantages make them well-suited to handle the section's
type of chemistry analyzer shall increasing workload while maintaining the effectiveness and dependability
they purchase to cope up with of testing procedures.
the increasing workload in the
section. She was made to Reference/Source:
choose between discrete or Seal Analytical (2013). Is Discrete or Continous Flow Analysis Best. https://www.seal-
analytical.com/News/Is-Discrete-or-Continuous-Flow-Analysis-
continuous flow analyzer. If you Best#:~:text=In%20general%20terms%2C%20discrete%20analyzers,a%20smaller%2
were Jane, what would be your 0number%20of%20chemistries.
preference flow analyzer?
Explain you’re your choice.
In a Clinical Chemistry forum, At the video presentation
you were asked to speak on the
Reference/Source
different measurement LabbCompare (n.d.). Clinical Chemistry Analyzers.
technologies available in the https://www.labcompare.com/Pharmaceutical-Lab-Equipment/879-Chemistry-
market. Prepare a presentation Analyzer-Clinical-Chemistry-
Analyzers/#:~:text=Clinical%20chemistry%20analyzers%2C%20also%20referred,seru
(narrated powerpoint or video m%2C%20plasma%2C%20and%20urine.
recorded) on each of the
Merck (n.d.). Photometry & Reflectometry.
measurement technologies and https://www.sigmaaldrich.com/PH/en/applications/analytical-chemistry/photometry-
give an example of a chemistry and-reflectometry
analyzer available for each. J.A. Cooper et. al. (2013). Assays for determining cell differentiation in biomaterials.
https://www.sciencedirect.com/topics/chemistry/colorimetry#:~:text=Colorimetric%20a
ssays%20use%20a%20colorimeter,chemical%20with%20the%20target%20substance

F. Martos, R. Rojas.(2016). Cobalt: Properties and Determiantion.

https://www.sciencedirect.com/topics/nursing-and-health-professions/ion-selective-
electrode

G. Hanrahan et. al. (2005). Water Analysis - Freshwater.

https://www.sciencedirect.com/topics/chemistry/ion-selective-electrode

Wanger A. et. al. (2017). Antigen and Antibody Testing.

https://www.sciencedirect.com/topics/medicine-and-dentistry/latex-agglutination-
test#:~:text=The%20latex%20agglutination%20reaction%20is,the%20surface%20of%
20latex%20particles.

8
 CLINICAL CHEMISTRY ANALYZERS

ON THE JOB TASK SHEET: PSYCHOMOTOR APPLICATION

Name: Ricah Mae O. Borral Date: June 18 2023

INSTRUCTION: Search from PRINTED OR ONLINE, OR VIDEO RECORDED valid references

information that would help in the achievement of the following learning outcomes. Follow this
template (cut this page or copy paste) for your answers and submit it according to the instruction of
your instructor. Use additional page if needed. PLEASE INDICATE THE SOURCE/S OF YOUR
ANSWERS.

ON-THE-JOB TASKS ANSWERS

Perform start-up procedure of (1) Precical diluent Store unopened diluent until the expiration date on
clinical chemistry analyzer. the vial. (2) RD Precical calibrator serum A human serum with added
chemicals, human and animal tissue extracts, and preservatives.
Constituent concentrations are specific for each lot used. Store
unopened Precical calibrator serum at 2–8C until the expiration date
on the vial. (a) Bring Precical diluent to 20–25C before use.
Video Link/ Source:
Kanagasabapathy A. and Kumari S. (2000). Guidelines on Standard Operating
Procedure for Clinical Chemistry.
https://apps.who.int/iris/rest/bitstreams/911202/retrieve

Barteng M. (2022). How to Start-Up and Perform Test Using Automated Clinical Chem
Analyzer. https://www.youtube.com/watch?v=yhY1B3f4gAs
Perform quality control Quality Control:
procedure in clinical chemistry 1. Each morning, all parameters are tested with control sera.
using an automated analyzer. Some parameters
are tested with control serum level 1 and control serum level 2,
which consists of lyophilised human plasma with a normal and
a pathological concentration.
Other parameters are tested with specific controls from other
suppliers.

2. Controls are thawed and vortexed before utilisation and

loaded according to the analyser’s display. Control values
must lie within the acceptable range indicated by the
manufacturer, otherwise the specific tests must be
recalibrated and specific measurements repeated. Controls can
be stored in 200µl aliquots at -20°C for up to 1 week.

Analysing results:
1. Samples that produce results that lie outside the linear range
for a specific assay have to be re-tested. In some cases it
may be necessary to dilute samples with water to bring test
results into range.
2. Validate the data.
3. Transfer the data to the database
9
 Video Link/ Source:
Kanagasabapathy A. and Kumari S. (2000). Guidelines on Standard Operating
Procedure for Clinical Chemistry.
https://apps.who.int/iris/rest/bitstreams/911202/retrieve

Randox Laboratories (2014). Tutorial: Guide to Running Quality Control.

https://www.youtube.com/watch?v=3JZcyaVmCQE
Perform clinical chemistry test Samples Collection and storage:
on a patient sample using an
automated analyzer. 1. Collect blood samples according to the blood sample
collection and handling
SOPs.
2. Keep whole blood samples on wet ice until
centrifugation and then keep serum samples on wet ice or in
the fridge until analysis (allowing them to reach room
temperature prior to analysis). Record whether samples are
kept on ice between collection and analysis.
3. Stability during storage varies between seum parameters. If
analyses are not performed on the day of collection, store
serum samples at minus 20°C.
4. Volume required: > 500µl.
5. Exclusion criteria: severe haemolysis.

Sample preparation:

1. Prepare the serum samples collected on the same day of

the measurement by centrifuge them at ~5000 x g for 3 -5
minutes.
2. If necessary, remove fibrinogen clots using a wooden
applicator.
3. Use serum samples undiluted or diluted to a ratio of 1:2 with
deionised water
or normal saline if the volume is insufficient.
4. Load the racks according to the work lists.

Video Link/ Source:

Kanagasabapathy A. and Kumari S. (2000). Guidelines on Standard Operating
Procedure for Clinical Chemistry.
https://apps.who.int/iris/rest/bitstreams/911202/retrieve

Barteng M. (2022). How to Start-Up and Perform Test Using Automated Clinical Chem
Analyzer. https://www.youtube.com/watch?v=yhY1B3f4gAs

10
 Activity 3
BLOOD GLUCOSE LEVEL: TESTING AND MONITORING

STUDENT JOB SHEET: LEARNER’S NOTES

Name: Ricah Mae O. Borral Date: June 18, 2023

INSTRUCTION: Search from PRINTED OR ONLINE, OR VIDEO RECORDED valid references

information that would help in the achievement of the following learning outcomes. Follow this
template (cut this page or copy paste) for your answers and submit it according to the instruction
of your instructor. Use additional page if needed. PLEASE INDICATE THE SOURCE/S OF YOUR
ANSWERS.

LEARNING OUTCOMES ANSWERS

Describe how glucose is

metabolized and stored. Glucose metabolism involves multiple processes, including
glycolysis, gluconeogenesis, and glycogenolysis, and
glycogenesis. Glycolysis in the liver is a process that involves
various enzymes that encourage glucose catabolism in cells.
One enzyme, in particular, glucokinase, allows the liver to
sense serum glucose levels and to utilize glucose when serum
glucose levels rise, for example, after eating. During periods of
fasting, when there is no glucose consumption, for example,
overnight while asleep, the process of gluconeogenesis takes
place.
Gluconeogenesis happens when there is glucose synthesis
from non-carbohydrate components in the mitochondria of liver
cells. Additionally, during fasting periods, the pancreas secretes
glucagon, which begins the glycogenolysis process. In
glycogenolysis, glycogen, the stored form of glucose, is
released as glucose. The process of synthesizing glycogen is
termed glycogenesis and occurs when excess carbohydrates
exist in the liver.
Source:

https://www.ncbi.nlm.nih.gov/books/NBK560599/#:~:text=Glucose%20metabolis
m%20involves%20multiple%20processes,encourage%20glucose%20catabolism
%20in%20cells.

11
Identify the normal range of
blood glucose for non-fasting
and fasting samples.

Source:
https://www.quora.com/What-is-the-normal-range-for-non-fasting-blood-glucose
List causes of abnormally low
and high blood glucose levels. Causes of Low Blood Sugar
There are many reasons why you may have low blood sugar,
including:

 Taking too much insulin.

 Not eating enough carbs for how much insulin you take.
 Timing of when you take your insulin.
 The amount and timing of physical activity.
 Drinking alcohol.
 How much fat, protein, and fiber are in your meal.
 Hot and humid weather.
 Unexpected changes in your schedule.
 Spending time at a high altitude.
 Going through puberty.
 Menstruation.

Causes of High Blood Sugar

A variety of things can trigger an increase in blood sugar level
in people with diabetes, including:

 stress
 an illness, such as a cold
 eating too much, such as snacking between meals
 a lack of exercise
 dehydration
 missing a dose of your diabetes medication, or taking an

12
 incorrect dose
 over-treating an episode of hypoglycaemia (low blood
sugar)
 taking certain medicines, such as steroid medication
 occasional episodes of hyperglycaemia can also occur
in children and young adults during growth spurts.

Source:

https://www.cdc.gov/diabetes/basics/low-blood-sugar.html

https://www.nhsinform.scot/illnesses-and-conditions/blood-and-
lymph/hyperglycaemia-high-blood-sugar

Explain the cause of diabetes

mellitus. What causes type 1 diabetes?

Type 1 diabetes occurs when your immune system, the body’s

system for fighting infection, attacks and destroys the insulin-
producing beta cells of the pancreas. Scientists think type 1
diabetes is caused by genes and environmental factors, such
as viruses, that might trigger the disease. Studies such
as TrialNet External link are working to pinpoint causes of type
1 diabetes and possible ways to prevent or slow the disease.

What causes type 2 diabetes?

Type 2 diabetes—the most common form of diabetes—is

caused by several factors, including lifestyle factors and genes.

Overweight, obesity, and physical inactivity

You are more likely to develop type 2 diabetes if you are not
physically active and are overweight or have obesity. Extra
weight sometimes causes insulin resistance and is common in
people with type 2 diabetes. The location of body fat also
makes a difference. Extra belly fat is linked to insulin resistance,
type 2 diabetes, and heart and blood vessel disease. To see if
your weight puts you at risk for type 2 diabetes, check out
these Body Mass Index (BMI) charts.

Insulin resistance

Type 2 diabetes usually begins with insulin resistance, a

condition in which muscle, liver, and fat cells do not use insulin
well. As a result, your body needs more insulin to
help glucose enter cells. At first, the pancreas makes more
insulin to keep up with the added demand. Over time, the
pancreas can’t make enough insulin, and blood glucose levels

13
rise.

Genes and family history

As in type 1 diabetes, certain genes may make you more likely

to develop type 2 diabetes. The disease tends to run in families
and occurs more often in these racial/ethnic groups:

 African Americans
 Alaska Natives
 American Indians
 Asian Americans
 Hispanics/Latinos
 Native Hawaiians
 Pacific Islanders

Genes also can increase the risk of type 2 diabetes by

increasing a person’s tendency to become overweight or have
obesity.

What causes gestational diabetes?

Scientists believe gestational diabetes, a type of diabetes that

develops during pregnancy, is caused by the hormonal changes
of pregnancy along with genetic and lifestyle factors.

Insulin resistance

Hormones produced by the placenta NIH external

link contribute to insulin resistance, which occurs in all women
during late pregnancy. Most pregnant women can produce
enough insulin to overcome insulin resistance, but some
cannot. Gestational diabetes occurs when the pancreas can’t
make enough insulin.

As with type 2 diabetes, extra weight is linked to gestational

diabetes. Women who are overweight or have obesity may
already have insulin resistance when they become pregnant.
Gaining too much weight during pregnancy may also be a
factor.

Genes and family history

Having a family history of diabetes makes it more likely that a

woman will develop gestational diabetes, which suggests that
genes play a role. Genes may also explain why the disorder
occurs more often in African Americans, American Indians,
Asians, and Hispanics/Latinas.

What else can cause diabetes?

14
Genetic mutations NIH external link, other diseases, damage to
the pancreas, and certain medicines may also cause diabetes.

Genetic mutations

 Monogenic diabetes is caused by mutations, or

changes, in a single gene. These changes are
usually passed through families, but sometimes the
gene mutation happens on its own. Most of these
gene mutations cause diabetes by making the
pancreas less able to make insulin. The most
common types of monogenic diabetes are neonatal
diabetes and maturity-onset diabetes of the young
(MODY). Neonatal diabetes occurs in the first 6
months of life. Doctors usually diagnose MODY
during adolescence or early adulthood, but
sometimes the disease is not diagnosed until later in
life.
 Cystic fibrosis NIH external link produces thick
mucus that causes scarring in the pancreas. This
scarring can prevent the pancreas from making
enough insulin.
 Hemochromatosis causes the body to store too
much iron. If the disease is not treated, iron can build
up in and damage the pancreas and other organs.

Hormonal diseases

Some hormonal diseases cause the body to produce too much

of certain hormones, which sometimes cause insulin resistance
and diabetes.

 Cushing’s syndrome occurs when the body produces

too much cortisol—often called the “stress hormone.”
 Acromegaly occurs when the body produces too
much growth hormone.
 Hyperthyroidism occurs when the thyroid gland
produces too much thyroid hormone.

Damage to or removal of the pancreas

Pancreatitis, pancreatic cancer, and trauma can all harm the

beta cells or make them less able to produce insulin, resulting
in diabetes. If the damaged pancreas is removed, diabetes will
occur due to the loss of the beta cells.

Medicines

Sometimes certain medicines can harm beta cells or disrupt the

way insulin works. These include

15
  niacin, a type of vitamin B3
 certain types of diuretics, also called water pills
 anti-seizure drugs
 psychiatric drugs
 drugs to treat human immunodeficiency virus
(HIV NIH external link)
 pentamidine, a drug used to treat a type of
pneumonia External link
 glucocorticoids—medicines used to treat
inflammatory illnesses such as rheumatoid
arthritis NIH external link, asthma NIH external
link, lupus NIH external link, and ulcerative colitis
 anti-rejection medicines, used to help stop the body
from rejecting a transplanted organ

Statins, which are medicines to reduce LDL (“bad”) cholesterol

levels, can slightly increase the chance that you’ll develop
diabetes. However, statins help protect you from heart disease
and stroke. For this reason, the strong benefits of taking statins
outweigh the small chance that you could develop diabetes.

Source:

https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-
causes#:~:text=Overweight%2C%20obesity%2C%20and%20physical%20inactivi
ty,fat%20also%20makes%20a%20difference.
Distinguish between type 1 and
type 2 diabetes mellitus. Type 1 diabetes is 10 times less common than Type 2
diabetes. Type 1 diabetes is caused by the body’s immune
system damaging the pancreas and, therefore, no insulin can
be manufactured by the body. In Type 1 diabetes, the body fails
to make insulin.

In Type 2 diabetes, the body either develops a resistance to

insulin or not enough insulin is produced to lower the blood
sugars. To date, except for family history, there are no known
risk factors for Type 1 diabetes. On the other hand, known risk
factors for Type 2 diabetes include advancing age, family
history, obesity, use of certain medications, sedentary lifestyle,
and ethnicity.

Type 1 diabetes has only one treatment: insulin replacement.

There is no other treatment for Type 1 diabetes and without
insulin, death is very likely. Whereas Type 2 diabetes can be
16
 managed with diet, weight loss, medications, and/or
insulin. Individuals with Type 1 diabetes tend to develop a life-
threatening condition called diabetic ketoacidosis. This
condition is chiefly due to the lack of insulin. On the other hand,
Type 2 diabetics tend to develop a condition called a
hyperosmolar coma, which is chiefly due to the high levels of
glucose in the bloodstream. There is no cure for Type 1
diabetes and insulin treatment is required for life; on the other
hand, with lifestyle changes, the symptoms of Type 2 diabetes
can be reduced or even completely eliminated.

Source:

https://canohealth.com/news/blog/the-difference-between-type-1-and-type-2-
diabetes/#:~:text=Type%201%20diabetes%20is%20caused,to%20lower%20the%20bl
ood%20sugars.
List several clinical and The most common symptoms of type 1 diabetes mellitus (DM)
biochemical characteristics of are polyuria, polydipsia, and polyphagia, along with lassitude,
type 1 diabetes mellitus. nausea, and blurred vision, all of which result from the
hyperglycemia itself. Polyuria is caused by osmotic diuresis
secondary to hyperglycemia.
The classical signs of Type 1 DM are thirst, polyuria, polydipsia
and weight loss. ketoacidosis) develop.
Signs and symptoms of type 1 diabetes can appear rather
suddenly, especially in children. They may include increased
thirst, frequent urination, bed wetting in children who previously
didn't wet the bed. Extreme hunger, unintended weight loss,
fatigue and weakness, blurred vision, irritability, and other mood
changes

Source:
https://emedicine.medscape.com/article/117739-clinical#:~:text=Presentation-
,History,osmotic%20diuresis%20secondary%20to%20hyperglycemia.
Compare and contrast blood A1C Test
glucose tests performed in
laboratory. The A1C test measures your average blood sugar level over
the past 2 or 3 months. An A1C below 5.7% is normal, between
5.7 and 6.4% indicates you have prediabetes, and 6.5% or
higher indicates you have diabetes.

Fasting Blood Sugar Test

This measures your blood sugar after an overnight fast (not

eating). A fasting blood sugar level of 99 mg/dL or lower is
normal, 100 to 125 mg/dL indicates you have prediabetes, and
126 mg/dL or higher indicates you have diabetes.

17
Glucose Tolerance Test

This measures your blood sugar before and after you drink a
liquid that contains glucose. You’ll fast (not eat) overnight
before the test and have your blood drawn to determine your
fasting blood sugar level. Then you’ll drink the liquid and have
your blood sugar level checked 1 hour, 2 hours, and possibly 3
hours afterward. At 2 hours, a blood sugar level of 140 mg/dL or
lower is considered normal, 140 to 199 mg/dL indicates you
have prediabetes, and 200 mg/dL or higher indicates you have
diabetes.

Random Blood Sugar Test

This measures your blood sugar at the time you’re tested. You
can take this test at any time and don’t need to fast (not eat)
first. A blood sugar level of 200 mg/dL or higher indicates you
have diabetes.

Result* A1C Test Fasting Blood Sugar Test Gluc

Diabetes 6.5% or above 126 mg/dL or above 200 mg

Prediabetes 5.7 – 6.4% 100 – 125 mg/dL 140 – 1

Normal Below 5.7% 99 mg/dL or below 140 mg

*Results for gestational diabetes can differ. Ask your health

care provider what your results mean if you’re being tested for
gestational diabetes.
Source: American Diabetes Association

If your doctor thinks you have type 1 diabetes, your blood may
also tested for autoantibodies (substances that indicate your
body is attacking itself) that are often present in type 1 diabetes
but not in type 2 diabetes. You may have your urine tested for
ketones (produced when your body burns fat for energy), which
also indicate type 1 diabetes instead of type 2 diabetes.

Tests for Gestational Diabetes

Gestational diabetes is diagnosed using blood tests. You’ll
probably be tested between 24 and 28 weeks of pregnancy. If
your risk is higher for getting gestational diabetes (due to
having more risk factors), your doctor may test you earlier.
Blood sugar that’s higher than normal early in your pregnancy
may indicate you have type 1 or type 2 diabetes rather than
gestational diabetes.

Glucose Screening Test

This measures your blood sugar at the time you’re tested. You’ll
drink a liquid that contains glucose, and then 1 hour later your
18
 blood will be drawn to check your blood sugar level. A normal
result is 140 mg/dL or lower. If your level is higher than 140
mg/dL, you’ll need to take a glucose tolerance test.

Glucose Tolerance Test

This measures your blood sugar before and after you drink a
liquid that contains glucose. You’ll fast (not eat) overnight
before the test and have your blood drawn to determine your
fasting blood sugar level. Then you’ll drink the liquid and have
your blood sugar level checked 1 hour, 2 hours, and possibly 3
hours afterward. Results can differ depending on the size of the
glucose drink and how often your blood sugar is tested.

Source:

https://www.cdc.gov/diabetes/basics/getting-tested.html
Describe how to care for a
glucose meter and blood Throw out damaged or outdated test strips. Store strips in their
glucose reagent strips.
sealed container; keep them away from moisture and humidity.

Be sure the strips are meant for your specific glucose meter.

Keep your glucose meter and test strips at room temperature.

Wash and dry your hands and the testing site thoroughly with

soap and water before pricking your skin. Don't use hand sanitizer

before testing. If using alcohol wipes, let the site completely dry

prior to pricking.

Fully insert the test strip into the monitor. Replace the monitor

batteries as needed. Replace the monitor every 4 to 5 years.

Touch a generous drop of blood to the test strip. Don't add more

blood to the test strip after the first drop is applied.

19
 If you're using a testing site other than your fingertip and you

think the reading is wrong, test again using blood from a fingertip.

Blood samples from alternate sites aren't as accurate as fingertip

samples when your blood sugar level is rising or falling quickly.

If you are dehydrated or your red blood cell count is low (anemia),

your test results may be less accurate.

Source:
https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/blood-
glucose-monitors/faq-
20057902#:~:text=Store%20strips%20in%20their%20sealed,for%20your%20spec
ific%20glucose%20meter.&text=Keep%20your%20glucose%20meter%20and%20
test%20strips%20at%20room%20temperature.&text=Wash%20and%20dry%20yo
ur%20hands,water%20before%20pricking%20your%20skin.
Explain the role of patient Regular blood sugar monitoring is the most important thing you
monitoring of blood glucose in can do to manage type 1 or type 2 diabetes. You’ll be able to
the management of type 1 see what makes your numbers go up or down, such as eating
diabetes mellitus. different foods, taking your medicine, or being physically active.
With this information, you can work with your health care team
to make decisions about your best diabetes care plan. These
decisions can help delay or prevent diabetes complications
such as heart attack, stroke, kidney disease, blindness, and
amputation. Your doctor will tell you when and how often to
check your blood sugar levels.

Most blood sugar meters allow you to save your results and you
can use an app on your cell phone to track your levels. If you
don’t have a smart phone, keep a written daily record like the
one in the photo. You should bring your meter, phone, or paper
record with you each time you visit your health care provider.

Source:
https://www.cdc.gov/diabetes/managing/managing-blood-
sugar/bloodglucosemonitoring.html#:~:text=Regular%20blood%20sugar%20mo
nitoring%20is,medicine%2C%20or%20being%20physically%20active.

20
 Activity 3
BLOOD GLUCOSE LEVEL: TESTING AND MONITORING

ON THE JOB TASK SHEET: COGNITIVE APPLICATION

Name: Ricah Mae O. Borral Date: June 18, 2023

INSTRUCTION: Search from PRINTED OR ONLINE, OR VIDEO RECORDED valid references

information that would help in the achievement of the following learning outcomes. Follow this
template (cut this page or copy paste) for your answers and submit it according to the instruction
of your instructor. Use additional page if needed. PLEASE INDICATE THE SOURCE/S OF YOUR
ANSWERS.

ON-THE-JOB TASKS ANSWERS

The lab where you work does Some people develop high blood sugar during pregnancy. This
blood glucose tests to monitor
condition is called gestational diabetes (GD). A healthy diet and
pregnant women at risk of
developing gestational diabetes. exercise can usually keep it under control, but sometimes
What items of medical history
insulin is needed to help you manage GD. If left untreated, it
identify those women at special
risk? can cause health problems for both mother and the fetus.

Although any woman can develop GDM during pregnancy,

some of the factors that may increase the risk include the
following:

 Overweight or obesity
 Family history of diabetes
 Having given birth previously to an infant weighing
greater than 9 pounds
 Age (women who are older than 25 are at a greater risk
for developing gestational diabetes than younger
women)
 Race (women who are African-American, American
Indian, Asian American, Hispanic or Latino, or Pacific
21
 Islander have a higher risk)
 Prediabetes, also known as impaired glucose tolerance

Reference/Source:
https://www.hopkinsmedicine.org/health/conditions-and-
diseases/diabetes/gestational-diabetes

One of your jobs in the A fasting blood sugar test measures sugar (glucose) in your
physician’s office where you
blood. It’s a simple, safe and common way to diagnose
work is to give patients
instructions in how to prepare for prediabetes, diabetes or gestational diabetes. A healthcare
lab tests. What instructionswould
provider will prick your finger or use a needle to draw blood
you give to Ms. Talbot, who is
going to have a fastingblood from a vein in your arm. Don’t eat or drink anything (except
sugar test performed tomorrow water) for 8 to 12 hours before the test.
morning?

Reference/Source:
https://medlineplus.gov/lab-tests/fasting-for-a-blood-test/
What instructions would you give Three days before the test, eat foods that are high in
to Mr. Chen, who is going to have carbohydrates. (This includes potatoes, breads, rice, and
a glucose tolerance test in 3 days? pastas.) This makes the test more accurate.
Do not eat or drink anything (other than sips of water) for 8 to
14 hours before your test. Also no smoking or gum chewing
before or during the test (You also cannot eat during the test.)
You will be asked to drink a liquid that contains glucose, 100
grams (g) . You will have blood drawn before you drink the
liquid, and again 3 more times every 60 minutes after you drink
it.

Reference/Source:
https://carteretobgyn.com/wp-content/uploads/2017/12/3-hour-glucose-
information-2017.pdf
https://medlineplus.gov/ency/article/007562.htm#:~:text=Do%20not%20eat%20or
%20drink,minutes%20after%20you%20drink%20it.
Today, in the laboratory where
you work, a patient’s glucose Impaired fasting glucose (IFG) is defined as fasting plasma
concentration remained above200 glucose (FPG) levels from 100 to 125 mg/dL (from 5.6 to 6.9
mg/dL at the end of the second
mmol/L) and impaired glucose tolerance as two-hour post
glucose levels during 75-gram OGTT from 140 to 199 mg/dL
hour of his glucose tolerance test.
(from 7.8 to 11.0 mmol/L). It should be noted that the World
How would youinterpret this
Health Organization and numerous other diabetes
result?
organizations define the IFG lower limit at 110 mg/dL (6.1
mmol/L).
The results of the OGTT as a screening test for type 2 diabetes
can be interpreted as follows:

22
  The 2-hour plasma glucose level <140 mg/dL is
considered normal
 The 2-hour plasma glucose level of 140-199 mg/dL
indicates impaired glucose tolerance
 The 2-hour plasma glucose level ≥200 mg/dL indicates
diabetes
For a diagnosis to be made, the test must be repeated on
another day shortly afterward, yielding similar results.
Alternatively, a diagnosis can be confirmed using one of the
other screening tests. A single abnormal OGTT is insufficient
for diagnosing diabetes or prediabetes.

Reference/Source:
https://www.ncbi.nlm.nih.gov/books/NBK532915/

23
The reagent strips that you use with Do not use discolored strips. Compare the color of the unused
the glucose meter in the laboratory strip to the negative area on the color chart provided by the
where you work haveturned a dark company. The color should be similar. Use another regeant
color. What should strip for reliability and accuracy of test results.
you do?

Reference/Source:
https://www.labce.com/spg130900_reagent_strip_precautions.aspx

A new patient with type 1 diabetes When to Check Blood Sugar Levels
needs instructions in home
monitoring of blood glucose levels.  Check your child's blood sugar level at the following
The doctor has asked you to explain
to the patient how to keep a
times:
permanent log of blood glucose
testing. What information should  Before meals and bedtime, a minimum of four times a
you tell the new patient to recordin day.
the log?
 If you suspect your child has a low blood sugar level.

 Before and after your child exercises.

 When your child is ill.

Two hours after the start of a meal, if results from before the
meal don't match HbA1c.

During the night. This is particularly important if your child had a

low blood sugar level during the day, exercised more than
usual, made a change in the insulin dose or has been ill.

How to Check Blood Sugar Levels

1. A health care professional will teach you and your child

how to properly use a blood glucose meter.

2. Clean hands with soap and water. Make sure the finger is
dry before obtaining the blood sample — wet fingers can
alter the value.

3. Prick the side of the fingertip. The forearm also can be

pricked with certain meters using a lancet device. Do not
use the forearm if you suspect a low blood sugar or when
the blood sugar is rapidly changing, such as after meals or
exercise.

4. Insert strip into meter.

5. Obtain a drop of blood.

6. Apply the drop of blood to a test strip.

24
 7. Read the result and enter it in a logbook.

8. Bring the meter and logbook to all doctor visits.

9. Suggested Glucose Target Ranges

The American Diabetes Association (ADA) published a position

statement in 2005 on the standard of care for children with type
1 diabetes. Below is a table with the ADA's recommendations
on age-specific blood sugar goal ranges. Blood glucose goals
should be higher than those listed in the table for children who
have frequent cases of hypoglycemia (low blood sugar levels)
and don't experience the associated signs and symptoms.

Your child's diabetes health care team will recommend an

individualized target range for blood sugar levels. The general
goal is to maintain as normal as possible blood sugar levels
without causing frequent low blood sugar. Research has shown
that in children under the age of 6, frequent, severe low blood
sugar levels may result in neuro-cognitive deficits — problems
related to intellectual ability — so target ranges are higher in
this age group.

Adolescents should strive to achieve similar target ranges as

adults. However, this may be difficult because of higher
hormone levels, such as growth hormones, which counteract
the effects of insulin. If your child's sugar levels are in the
ranges listed below at least 50 percent of the time, then blood
sugar control is considered reasonable. If sugars levels exceed
the range more than 50 percent of the time, then sugar control
is not optimal and the diabetes plan should be changed.

Plasma Blood Glucose Goal Range

Values by age Before

Bedtime/overnight AIC
(years) Meals

110-200 mg/dl
Toddlers and
100-180
preschoolers — 7.5 to 8.5
mg/dl
(under age 6)
percent

School age (6– 90-180 100-180 mg/dl —

25
 12 years) mg/dl less than 8

percent

Adolescents 90-150 mg/dl —

and young 90-130
less than 7.5
adults (13–19 mg/dl
years) percent

Reference/Source:
https://www.ucsfbenioffchildrens.org/education/tips-for-checking-blood-sugar
After a meal the blood glucose A spike in insulin signals the liver that a person's blood glucose
level begins to rise. level is also high, causing the liver to absorb glucose and
Describe the processes which change it into glycogen. When blood sugar levels
occur in the human body to bring drop, glucagon instructs the liver to convert the glycogen back
the level of glucose in theblood
to glucose, causing a person's blood sugar levels to return to
back down to its normal
level. normal.

Reference/Source:

https://www.medicalnewstoday.com/articles/316427#:~:text=A%20spike%20in%
20insulin%20signals,levels%20to%20return%20to%20normal.
What risk factors patients with Type 1 diabetes is thought to be caused by an immune reaction
diabetes most likely to develop? (the body attacks itself by mistake). Risk factors for type 1
diabetes are not as clear as for prediabetes and type 2
diabetes. Known risk factors include:

 Family history: Having a parent, brother, or sister with

type 1 diabetes.
 Age: You can get type 1 diabetes at any age, but it
usually develops in children, teens, or young adults.
In the United States, White people are more likely to develop
type 1 diabetes than African American and Hispanic or Latino
people.

Currently, no one knows how to prevent type 1 diabetes.

What are the risk factors for type 2 diabetes?

Diabetes type 2 can affect people at any age.

You can develop type 2 diabetes at any age, even during

childhood. You are more likely to develop type 2 diabetes if
you1

 are overweight or have obesity.

 are age 35 or older. Children and teens can also
26
 develop type 2 diabetes, but the risk increases as a
person gets older.
 have a family history of diabetes.
 are African American, American Indian, Asian
American, Hispanic/Latino, or Pacific Islander.
 are not physically active, because of physical
limitations, a sedentary lifestyle, or a job that requires
sitting for long periods of time.
 have prediabetes.
 have a history of gestational diabetes, a type of
diabetes that develops during pregnancy, or gave
birth to a baby weighing 9 pounds or more.

Children and teens are also at higher risk of developing type 2

diabetes if, in addition to the previous risk factors, they were
born with a low birth weight or if their parent had gestational
diabetes while pregnant with the child. 1

You’re at risk for type 2 diabetes if you:

 Have prediabetes.
 Are overweight.
 Are 45 years or older.
 Have a parent, brother, or sister with type 2 diabetes.
 Are physically active less than 3 times a week.
 Have ever had gestational diabetes (diabetes during
pregnancy) or given birth to a baby who weighed over 9
pounds.
 Are an African American, Hispanic or Latino, American
Indian, or Alaska Native person. Some Pacific Islanders
and Asian American people are also at higher risk.
If you have non-alcoholic fatty liver disease you may also be at
risk for type 2 diabetes.

You can prevent or delay type 2 diabetes with proven lifestyle

changes. These include losing weight if you’re
overweight, eating a healthy diet, and getting regular physical
activity.

Reference/Source:
https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-
type-2-diabetes
https://www.cdc.gov/diabetes/basics/risk-factors.html

27
 Activity 3
BLOOD GLUCOSE LEVEL: TESTING AND MONITORING

ON THE JOB TASK SHEET: PSYCHOMOTOR APPLICATION

Name: Ricah Mae O. Borral Date: June 18, 2023

INSTRUCTION: Search from PRINTED OR ONLINE, OR VIDEO RECORDED valid references

information that would help in the achievement of the following learning outcomes. Follow this
template (cut this page or copy paste) for your answers and submit it according to the instruction
of your instructor. Use additional page if needed. PLEASE INDICATE THE SOURCE/S OF YOUR
ANSWERS.

ON-THE-JOB TASKS ANSWERS

Perform a quality control test on The QC testing on glucometer is performed using at least two
blood glucose. concentrations of reference materials provided by the
manufacturer and compared against the recommended target
ranges. This testing is commonly performed once a day by a
key operator
Inserting the Test Strip
1. Take a test strip from the test strip container and immediately
close the container tightly to protect the remaining strips from
humidity.
2. Insert the test strip into the meter in the direction of the
arrows.
 The meter turns on and a code number displays on the
screen.
3. Compare the code number on the screen with the code
number on the test strip container and ensure that they are the
same.
 The code number disappears after a few seconds. If you did
not see the code number, remove the test strip from the meter
and reinsert it so it displays again.
 After the code disappears from the screen, a test strip and a
flashing blood drop symbol appears; this shows that the meter
is ready to test. Applying the Quality Control Solution
1. Put the meter on a flat surface.
2. Select the QC solution to be tested.
 The level of the QC solution is entered in the meter later.
 Ensure that the QC solution has not expired. The QC
solutions can be used until the expiry date on the vial label or
for 90 days from the date they were first opened, whichever
comes first.
3. Mix the QC solutions by gently inverting the bottle 5 times.
4. Take off the cap of the QC solution vial and wipe the tip of
28
 Activity 3
the vial with a tissue to remove any dried residue.
 If you are opening the QC vial for the first time, write the date
opened on the vial label.
5. Discard the first drop of QC solution.
6. Touch the second drop of QC solution to the front edge of the
yellow window at the end of the test strip.
 When enough QC solution is applied to the test strip, an
hourglass symbol flashes on the screen to show that the meter
is analyzing the QC solution.
 Result appears on the screen in 5 seconds, along with the
control bottle symbol and flashing “L.” Do not remove the test
strip at this point.

7. Use the forward arrow button ( ) to specify the level of the QC

solution that you used:
 If you used the QC solution vial 1, press the arrow button
once.
 If you used the QC solution vial 2, press the arrow button
twice.

8. Press the on/off/set button ( ) to save the level in the meter.

Reviewing and Documenting the Result 1. Review the results.
 If the result is within acceptable range, the word OK and the
result alternate on the screen.
If results remain outside acceptable range after two attempts:
Do not use the meter for patient testing; refer the patient tests
to the laboratory and contact the POCT lab for troubleshooting
assistance. Document the result on your Point of Care
Quality Assurance & Maintenance Record form. Finishing the
test
1. Put the cap securely back on the correct control solution bottle.
 QC solution vial 1 = grey cap.
 QC solution vial 2 = white cap.
2. Remove the used test strip.
 The meter turns off automatically 5 seconds after the test
strip is removed.
3. Dispose of the used test strip as per approved Island Health
guidelines.
4. Repeat the test using the second QC solution vial.
 Patient testing cannot be done until both levels of quality
control (using QC solution vials 1 and 2) are performed and OK
displays on the screen for both tests.

Video Link/ Source:

https://www.youtube.com/watch?v=XzvPBmt3a6M

https://www.youtube.com/watch?v=j1I1S0_vgPQ

29
 Activity 3
Perform whole blood glucose test
using manual method or Patients are instructed to obtain a blood sample by pricking
automated chemistry analyzer. their fingertip with a lancet. Spring-loaded lancets are available.
They are easy to use and cause minimal discomfort.
Surprisingly, many patients consider the discomfort of the finger
stick preferable to the inconvenience and aesthetic
unpleasantness of obtaining a urine sample for testing. A drop
of whole capillary blood is then placed on the reagent bonded to
the paper strip. Instead of using a known volume of blood, an
excess of blood is exposed to a fixed quantity of glucose
oxidase for a finite period of time to estimate concentration.
After the specified time, usually 1 minute, the excess blood is
removed by washing or wiping and the color is allowed to
develop. The concentration is then estimated by comparing to a
color chart, or by using a portable reflectance meter specific to
the reagent strip, to measure the developed color. Reflectance
meters for measuring blood glucose are becoming increasingly
sophisticated, compact, and reliable. Shirt-pocket-size models
are now available, and prototype models that store the time,
date, result, and insulin doses for later graphic printing at the
patient's home or physician's office have been developed.
Undoubtedly, reflectance meters that have access to complex
algorithms for recommending changes in insulin dose
individualized to a specific patient will be possible in the near
future.
Video Link/ Source:

https://www.google.com/search?sxsrf=APwXEde2MxBJr1baFPVrYhzGEQ11wh6
VPg:1687667866877&q=whole+blood+glucose+test+using+manual+method+of+
automated+chemistry+analyzer&tbm=vid&sa=X&ved=2ahUKEwjCu9DdzN3_Ah
Wh2jgGHa15D_IQ0pQJegQICBAB&biw=908&bih=777&dpr=0.75#fpstate=ive&vld
=cid:85ed8924,vid:zk8HRYiXYqo

https://www.youtube.com/watch?v=ogUgKpkQ4c4

30
Activity 3

31