Abstract
ObjectivesThis study aimed to evaluate whether a shorter fasting duration of five to six hours can be used as an alternative to the usually recommended eight hours for fasting glucose measurement.MethodsThis one-month observational, cross-sectional study was conducted during Ramadan (May to June) 2019. It included those attending Faiha Specialized Diabetes, Endocrine and Metabolism Center, Basrah, Iraq; all individuals ate a pre-dawn meal (suhoor) followed by a complete fast for many hours. Two fasting serum glucose (FSG) venous samples were taken; the first was taken five to six hours and the second eight hours after the pre-dawn meal. Participants were divided into two groups: individuals with type 2 diabetes mellitus (T2DM) and those with a normal glucose level. T2DM patients were further subdivided into three groups: those without treatment, those on oral antidiabetic drugs (OAD) and those using insulin and OAD.ResultsA total of 200 individuals participated in this study. There was no significant difference found between the mean FSG levels in the first and second samples for those without T2DM (104.5 ± 21.4 mg/dL versus 104.8 ± 12.6 mg/dL; P = 0.80) as well as those with T2DM (235.0 ± 107.0 mg/dL versus 230.0 ± 105.0 mg/dL; P = 0.20). Untreated T2DM patients had non-significant FSG readings for the two samples (194.0 ± 151.5 mg/dL versus 193.9 ± 128.9 mg/dL; P = 0.90). Patients on insulin and OAD showed a similar pattern of FSG (268.0 ± 111.0 mg/dL versus 269.0 ± 114.0 mg/dL). However, the two FSG samples were found to be significantly different among patients on OAD (220.0 ± 78.0 mg/dL versus 207.0 ± 77.0 mg/dL; P = 0.01).ConclusionThe fasting duration of five to six hours can give a comparable measurement of FSG as that obtained after eight hours.
Highlights
Disruption in the typical cyclical pattern of glucose tolerance is the hallmark of type 2 diabetes mellitus (T2DM), understanding the normal control of glucose metabolism hour by hour is critical for achieving optimal diabetes care
This study aims to evaluate whether a shorter fasting duration of five to six hours can substitute the standard glucose measurement using eight hours overnight fast
Among T2DM patients treated by oral antidiabetic drugs (OAD), the fasting serum glucose (FSG) mean values were 220.0 ± 78 mg/dL (12.21 ± 4.33 mmol/L) after five to six hours and 207 ± 77 mg/dL (11.49 ± 4.27 mmol/L) after eight hours of overnight fasting, with a mean significant difference of 13.1 ± 37.8 mg/ dL (0.73 ± 2.10 mmol/L), while for patients on insulin with OAD, the FSG mean values were 268 ± 111 mg/dL (14.87 ± 6.16 mmol/L) and 269 ± 114 mg/dL (14.93 ± 6.33 mmol/L) respectively with a mean insignificant difference of -1.4 ± 54.7 mg/dL (0.08 ± 3.04 mmol/L) (Table 2 and Figure 1)
Summary
Disruption in the typical cyclical pattern of glucose tolerance is the hallmark of type 2 diabetes mellitus (T2DM), understanding the normal control of glucose metabolism hour by hour is critical for achieving optimal diabetes care. Plasma is devoid of red and white blood cells, they still contain platelets, which consume glucose over time. Serum would be free from any cells, and it would be suitable for blood glucose estimation when there is a time delay in the measurement. Blood glucose measured in fluoride plasma correlated linearly with blood glucose in the serum, and serum value is lower than the corresponding fluoride plasma value by 1.15%. Serum may be used alternatively for blood glucose determination with an error of 1.15%.8
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