Oral Glucose Tolerance Test Instruction Guide DIY Kit

Post samples… Table of contents AFTER the blood spot cards dry: Check all blood spot cards and the results form for participant ID. If participant ID is not present, then fill it in on each card and the result form. Place each blood spot card in a separate foil biohazard bag. Each bag has a drying agent in it. Leave the drying agent in the bag and place your blood spot card in there with it. Squeeze the air out of the foil biohazard bag and seal. Place all 5 foil biohazard bags and your results form in the return envelope. Post your samples the same day you complete the test. Welcome..................................... 2 In this kit………………………….. 3 The night before………………… 4 Fasting Prepare testing and drying area Prepare glucose solution In the morning……...................... 5 Prepare glucose meter Warm up The test…………………………... 6 The test in six steps Collect your blood on blood spot card Measure and record blood glucose level Post samples…………………….. 8 8

Do not squeeze your fingertip! Welcome! Collect your blood on the blood spot card: Carefully twist off the lancet cap to open. Open the alcohol wipe and clean the tip of the finger (you may use a different finger for each sample). Place the white tip of the lancet on your fingertip and press it firmly against your finger until it clicks. Remove the first drop of blood with a tissue or a compress. Use the next large drop of blood. Start in the middle of the first circle on the left of the blood spot card. Let the drop of blood (but not the finger) come into contact with the filter paper. Fill all 5 circles completely. Set aside open blood spot card for drying for next 2 to 3 hours. Read all the instructions before you begin. Thank you for participating in the Do It Yourself (DIY) Oral Glucose Tolerance Test (OGTT)! With this test we can see how well you process sugar by looking at your blood glucose and insulin levels. This test needs to be done in the morning after an overnight fast which will take about 3 hours. You will need to fast for at least 10 hours. When you fast, you cannot eat, drink or exercise. However, you may sip water as necessary. We recommend you begin your fast at 10:00 pm/22:00 the night before and begin the OGTT test at or before 8:00 am/08:00 BEFORE you eat the next morning. Do not eat, drink or exercise until all samples have been taken. Choose a day the post office is open to conduct your test so you can ship your results form and samples the same day. Before you mail your samples, make sure your participant ID is on the results form and the blood spot cards. You may also record your blood glucose measurements on the online portal (https://humanstudies.tno.nl/nrc/). Do not squeeze your fingertip! Measure your blood glucose: Use a new glucose stick for each sample. Make sure your glucose meter is still on. If not press the start button again. Form another blood drop on your finger tip. Place this blood drop at the front end of the glucose test strip. It will automatically be absorbed. When enough blood is absorbed, the glucose meter will begin the measurement. Write down the measurement and exact time it was taken on the results form. You can also record the measurement on the online portal (https://humanstudies.tno.nl/nrc/). Throw the test strip and lancet away in a trash bin. Apply pressure to your fingertip with a tissue or compress and put on a plaster. 2 7

5 sample collection bags The test… In this kit… Sample 1 is before t=0: (sample 1 is before the stopwatch starts) Open the sample collection bag labeled 1. Collect your blood on the blood spot card. Measure your blood glucose. Move arm up and down. Single items: 1 return envelope 1 results form 1 glucose meter 1 jar of glucose strips 1 jar of glucose 5 sample collection bags: 1 blood spot card 1 lancet 1 compress 1 alcohol wipe 1 plaster 1 foil biohazard bag 1 reserve bag: 2 lancets 2 glucose strips Run warm water over hand. Start stopwatch and drink glucose solution: Get the glucose solution and mix thoroughly. Start your stopwatch. Immediately begin to drink the glucose solution and finish it within 5 minutes. Massage palm toward fingers. 5 sample collection bags Biohazard bags contain a drying agent. Do not remove this! Sample 2 at t=30: (sample 2 is 30 minutes after stopwatch starts) Open the sample collection bag labeled 2. Collect your blood on the blood spot card. Measure your blood glucose. Rub both hands together. Sample 3 at t=60: (sample 3 is 60 minutes after stopwatch starts) Open the sample collection bag labeled 3. Collect your blood on the blood spot card. Measure your blood glucose. Do not use little blood drops. Do not overfill circles. Sample 4 at t=90: (sample 4 is 90 minutes after stopwatch starts) Open the sample collection bag labeled 4. Collect your blood on the blood spot card. Measure your blood glucose. 1 reserve bag Do not drag finger on card. You also need tissues and a stopwatch. Sample 5 at t=120: (sample 5 is 120 minutes after stopwatch starts) Open the sample collection bag labeled 5. Collect your blood on the blood spot card. Measure your blood glucose. Do not expose card to sunlight, heat, or dust. 6 3

The night before… In the morning… 4 5 Do not exercise, eat or drink anything for at least 10 hours before the test. We suggest fasting after 10pm/22:00. Sipping water is ok. Do not exercise, eat or drink until after the test is completed. We suggest taking your first sample at 8am/08:00. Sipping water is ok. Set up your test and drying areas: Set up a clean surface for your test. Set up a place to dry your blood spot cards. We recommend setting up a drawer or cupboard for drying blood spot cards. Wash your hands thoroughly with soap and warm water for 1-2 minutes and dry them with a clean towel before you touch the equipment. Lay out the 5 sample collection bags in order (1, 2, 3, 4, 5), the glucose meter, glucose strips, and results form with a pen. Prepare the glucose solution: Pour all the glucose from the glucose jar into a container that can hold 300ml of water or more. We recommend using a container with a seal tight lid. Add 250ml of hot water. Stir until dissolved. Seal and refrigerate. Set up your glucose meter: Handle the test strip on the sides and put it in the glucose meter so that the triangular end sticks out the bottom. You will hear a few beeps and icons will appear on the display. Push the start button on the right hand side. You will now see a flashing blood drop on the display. Warm up: (You may perform these actions anytime during the test to encourage good blood flow.) Run your hands under warm water. Move your arms or hands up and down. Rub your hands together. Rub the palm of your hand toward your fingers. Set up your stopwatch: (You may use a smartphone as your stopwatch.) Sample 1 is taken before you start the stopwatch. Be prepared to drink your glucose solution immediately after you start your stopwatch and finish it within the first 5 minutes. Continuously run your stopwatch during the test. You will take samples 2, 3, 4, and 5 at 30, 60, 90, and 120 minutes respectively. 4 5