Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (963 page)

   Strenuous exercise, strong emotions, shock, burns, and infections can increase glucose physiologically.

Suggested Readings

American Diabetes Association Clinical Practice Recommendations: Executive Summary. Standards of Medical Care in Diabetes—2010.
Diabetes Care.
2010;33(Suppl 1):S11–S69.

Sacks D, Bruns DE, Goldstein DE, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.
Clin Chem.
2002;48(3):436–472.

GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD)

   Definition

   G6PD catalyzes the initial step in the hexose monophosphate shunt and is critical in protecting RBCs from oxidant injury. Deficiency of G6PD results in rigidity and lysis of RBCs, preferentially affecting older cells. G6PD deficiency is a hereditary (sex linked) abnormality.

   
Screening assay:
reported as normal or deficient.

   
Normal range (quantitative assay):
7.0–20.5 U/g Hb.

   Use

   The G6PD assay is used when G6PD deficiency is suspected (abnormal red cell break down).

   Interpretation

Decreased In

   Hemolytic anemia

   All persons with favism (but not all persons with decreased G6PD have favism)

   Limitation

   This assay should not be used following a hemolytic crisis in African Americans who carry the A
⁻
variant, because reticulocytes (elevated after acute hemolysis) may have sufficient enzyme to give erroneous normal results. Most individuals with G6PD deficiency as appropriate.

GROWTH HORMONE (GH)

   Definition