Demonstration of Fasting BS and RBS.pptx
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DEMONSTRATION OF FASTING BLOOD SUGAR AND RANDOM BLOOD SUGAR.
Demonstration of Fasting BS and RBS.pptx
- 1. The title of the college here along with a brief description if required Demonstration of FBS and RBS Arvind Kumar Deptt. of Biochemistry JNMC
- 2. Learning objectives • Define RBS and FBS and its significance in clinical practice • Regulation • List the indications and normal reference ranges. • Identify the required materials and prepare for the procedure. • Interpret test results • Precautions
- 3. Introduction • A blood sugar test measures the amount of sugar called glucose in a blood sample. • Glucose is a major energy source for most body cells, including brain cells. • Glucose is a building block for carbohydrates. • Carbohydrates are quickly turned into glucose in the body. This can raise blood glucose levels. • The hormone insulin made in the body helps control the blood glucose level.
- 5. Sources of glucose in the blood The main sources of blood glucose are: 1.Diet – Carbohydrates from food are broken down into glucose. 2.Glycogenolysis – The liver breaks down stored glycogen into glucose. 3.Gluconeogenesis – The liver and kidneys produce glucose from non-carbohydrate sources like amino acids, lactate, and glycerol.
- 8. Purpose of blood sugar testing • To diagnose and monitor diabetes in known or suspected diabetic patients. • To assess acute hyperglycemia or hypoglycemia in emergencies. • To monitor blood glucose control in hospitalized patients or those receiving insulin therapy. • To provide immediate results that can guide medical decision-making.
- 9. Choice of Estimation Method ┌──────────┴──────────┐ ▼ ▼ Qualitative Test Quantitative Test │ │ ▼ ▼ Benedict’s Test GOD-POD Method Fehling’s Test Folin-Wu Method (Color change) O-Toluidine Method │ │ ▼ ▼ Observation Absorbance Measurement
- 10. Classification of Quantitative Glucose Tests Based on Timing • Fasting Blood Sugar (FBS) – Measured after 10–12 hours of fasting. Normal: 70– 110 mg/dL. Used for diabetes diagnosis. • Postprandial Blood Sugar (PPBS) – Checked 1.5-2 hours after a meal. Normal: 70-140 mg/dL. Assesses glucose metabolism post-food. • Random Blood Sugar (RBS) – Taken anytime, regardless of meals. Normal: 70-140 mg/dL. Quick screening tool.
- 11. Random blood sugar • Random Blood Sugar (RBS) is a test that measures the glucose level in blood at any time of the day, regardless of when the patient last ate. • RBS can be taken without fasting, making it useful for quick blood glucose screening and monitoring.
- 12. Fasting blood sugar • Fasting Blood Sugar (FBS) is a test that measures blood glucose levels after an overnight fast of at least 10–12 hours. • It provides an accurate baseline glucose level and is commonly used for diabetes diagnosis and management.
- 13. Reference range Conditions RBS Reference range (mg/dl) Clinical significance Normal 70 – 140 mg/dl Normal glucose regulation Prediabetes 141 – 199 mg/dl Increased risk of diabetes Diabetes > 200 mg/dl Indicative of diabetes Hypoglycemia < 70 mg/dl Required immediate intervention
- 14. Conditions FBS Reference range (mg/dl) Clinical significance Normal 70 – 110 mg/dl Normal glucose regulation Prediabetes 111 – 125 mg/dl Increased risk of diabetes Diabetes > 126 mg/dl Indicative of diabetes Hypoglycemia < 70 mg/dl Required immediate intervention
- 15. Equipment & materials required for sample collection Equipment Purpose Sterile Syringe (2–5 mL) Used to collect venous blood Needle (Gauge 21–23) For venipuncture Fluoride Tube - Grey Cap Prevents glycolysis and preserves glucose Alcohol Swab Disinfects the venipuncture site Tourniquet Helps locate and stabilize the vein Gloves Prevents infection and cross-contamination Label & Marker For proper sample identification
- 18. Pre-test preparation • Introduce Yourself & Explain the Procedure – Introduce yourself to the patient and explain the need for RBS testing. – For FBS Confirm the patient has fasted for at least 10–12 hours (only water is allowed). – Obtain verbal consent from the patient. • Hand Hygiene & Personal Protective Equipment (PPE) – Wash hands using soap and water or use hand sanitiser. – Wear disposable gloves to prevent infection. • Assess the Patient’s Condition – Ask the patient about their last meal or medication intake, which may affect results.
- 19. Locating the vein & preparing the site • Apply a Tourniquet – Apply a tourniquet 3–4 inches above the puncture site to make the vein more prominent. – Ask the patient to make a fist (do not pump). • Select a Suitable Vein – The median cubital vein in the antecubital fossa is preferred. – Alternate sites: Cephalic vein, basilic vein. • Disinfect the Site – Clean the area using an alcohol swab in a circular motion. – Allow the skin to air dry before puncturing.
- 21. Venipuncture & blood collection • Hold the Syringe & Insert the Needle • Aspirate Blood into the Syringe • Release the Tourniquet • Withdraw the Needle & Apply Pressure
- 23. Transferring blood to the collection tube • Open the Fluoride (Grey Cap) Tube – This tube contains sodium fluoride, which prevents glucose breakdown. • Insert the Needle into the Tube & Transfer the Blood – Push the needle through the rubber cap and allow blood to flow into the tube. – Do not forcefully push the blood, as it may cause hemolysis. • Invert the Tube Gently 5–8 Times – Ensures proper mixing of blood with the sodium fluoride.
- 24. Post-test care • Apply gentle pressure with cotton/gauze to stop bleeding. • Label the Blood Sample - Write the patient’s name, date, time, and test type (FBS/RBS) on the tube. • Dispose of Used Equipment Safely • Remove Gloves & Wash Hands • Send the Sample to the Laboratory Immediately. For FBS, ensure the sample reaches the lab within 30–60 minutes. For RBS, processing can be done immediately.
- 25. Precautions • Ensure fasting for FBS (10–12 hours) before collecting the sample. • Do not shake the blood tube forcefully to avoid hemolysis. • Use a proper gauge needle (21–23G) for venipuncture. • Do not leave the tourniquet for more than 1 minute to prevent hemoconcentration. • Ensure proper disposal of used needles in sharps containers. • If the patient has fragile veins, use a butterfly needle instead of a syringe.
- 26. Causes of abnormal blood glucose levels Persistent Hyperglycemia Transient Hyperglycemia Persistent Hypoglycemia Transient Hypoglycemia Reference Range, FBG: 70-110 mg/dl, RBS 70-140 mg/dl Diabetes Mellitus Pheochromocytoma Insulinoma Acute Alcohol Ingestion Adrenal cortical hyperactivity Cushing's Syndrome Severe Liver Disease Adrenal cortical insufficiency Addison's Disease Drugs: salicylates, antituberculosis agents Hyperthyroidism Acute stress reaction Hypopituitarism Severe Liver disease Acromegaly Shock Galactosemia Several Glycogen storage diseases Obesity Convulsions Ectopic Insulin production from tumors Hereditary fructose intolerance
- 27. Summary
- 28. Thank You