What's going on with high and low blood sugar?

" It's strange, DRICU said that just now our emergency laboratory reported a blood glucose critical value of 1.1mmol/L, said we are not allowed, their bedside test is more than 10 o'clockThe patient died just now when the rescue was ineffectiveAsk if we did wrong, afraid of family trouble? "Colleague Xiao Wang was busy talking to everyone about it when he got the callheard about this, let me wonder, according to the saying that we report the critical value will be reviewed again, correct after we report the clinicalIf there is a problem with the specimen, will the test will be found in time and notify the clinical re-extraction of the specimen? I hurried to the emergency department to find the patient samples and look at them againspecimens are non-soluble, no milk, no coagulation, not infusion of blood is a qualified specimenDue to the dry chemical method used in the blood glucose test in the emergency laboratory, I again tested the specimen with the large biochemical instrument wet chemical method (glucose oxidase method)The results of the test came out soon, and the blood sugar 0.89mmol/L matched the results of the emergency biochemical instrumentWhat's the reason? Why is this such a big gap?I opened the history test sheet from my computer and tried to find traces againSuddenly found that the sampling time is 5:30am, and the emergency laboratory received the specimen time of 7:24am, the reporttime is 8:21am, it is 2 hours after the blood draw to send the specimenPeers who do the test know that the specimen should be collected immediately after the test, if the time is too long will cause red blood cell energy metabolism through sugar-effective use of glucose, over time to extend blood sugar will gradually reduce, an hourly reduction of 6% to 10%Looking through the patient's medical records, I found that the patient at about 1:16 am that day to rescue, to give norepinephrine, calcium gluconate, diuretics and other drugsTelephone inquiry bedside blood sugar detection is about the time to rescue, that blood sugar more than 10 points of the question will be solvedelevated blood sugar can be caused by stress stimulation, and drug action can produce an over-reactive increaseIs there any other reason why blood sugar has dropped so low? Again from the case found that the patient is also a patient with advanced cirrhosis, we all know that the liver is involved in three metabolism, patients with advanced cirrhosis of liver glycogen synthesis in the body decreased, resulting in a drop in blood sugar Analysis here solved the mystery, the patient's blood sugar decline of the two main reasons are sent for too long, liver damage liver glycogen synthesis decline caused why the reasons for the sudden high and low blood sugar found, I hastened to communicate with clinicians by telephone, to remove clinical doubts, so as to effectively avoid disputes Therefore, it is important to strengthen communication between clinics Zhao Jing Source: Review: nnjwbhuang on 2020-5-15 Comment: good article Thanks for sharing! (from: MedSci Medical APP )