Final answer:
When a phlebotomist gets 2 divergent glucometer results, they should re-test the sample, troubleshoot the glucometer, and check for user errors or test-strip issues. Further testing may be necessary to confirm results or to differentiate the type of diabetes if the GTT is positive.
Step-by-step explanation:
When a phlebotomist observes 2 widely divergent test results in a glucometer, especially during a glucose tolerance test, it is important to first confirm the validity of the results. A step that should be taken includes re-testing the sample to eliminate any possibility of an error in the testing process or the handling of the glucometer. If the results continue to be inconsistent, the phlebotomist should troubleshoot the glucometer to ensure it is working properly. This may involve checking the device for any visible signs of defect, verifying that it is calibrated correctly, and ensuring that the test strips are not expired or damaged. Additionally, factors such as patient hydration, hematocrit levels, and test-site preparation should be considered as they can affect test outcomes. Once all operational and external factors have been ruled out or addressed, further steps such as consulting with a supervisor or requesting laboratory confirmation using more precise methods, like the reflectometric hexokinase method, may be necessary.
In cases where a glucose tolerance test (GTT) is positive, indicating a confirmed diagnosis of diabetes mellitus, it is critical to perform further investigations to determine the type of diabetes. This can involve the Insulin Tolerance Test (ITT) or the Glucagon Tolerance Test (GuTT). For patients who may be showing signs of hormone resistance, as seen in type 2 diabetes where cells do not respond to insulin efficiently, changes in medication and diet may be required to manage the condition effectively.