Failure to appreciate the differences between arterial and venous blood glucose is a major cause of the confusion that has surrounded the recognition and diagnosis of hypoglycemia and been responsible for nonhypoglycaemia becoming a common diagnosis amongst those whom Singer and coworkers refer to as, the folk sector.
In the fasting subject the concentration of glucose in arterial and venous blood is virtually identical but may differ by as much as 2.5 mmol following ingestion of a carbohydrate-rich meal. Because it is arterial blood glucose that determines glucose supply to the brain, regulates the secretion of insulin and other hormones, and is itself homeostatically controlled, it is necessary to define hypoglycemia in terms of glucose in arterial (or more realistically free flowing capillary) than in venous blood.
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