Which condition commonly makes a fasting glucose specimen lipemic?

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Lipemia is the presence of unusually high lipid content in plasma, which makes the plasma appear milky or turbid. This turbidity is what you’re seeing in a fasting glucose specimen when the sample is lipemic, because abundant triglycerides in the blood scatter light and interfere with photometric glucose measurements. In a fasting state, most people expect clear plasma, but conditions like hypertriglyceridemia, metabolic disorders, obesity, or recent fatty intake can still produce a lipemic sample, and that lipemia is what causes the abnormal appearance and potential interference with the glucose result. The other options describe different interferences: icteric samples are yellow from bilirubin, hemolyzed samples are red from ruptured red cells, and cold samples involve cryoprecipitates or other issues not related to lipid content. When a sample is lipemic, labs may note the interference, attempt to clear lipids by centrifugation, or redraw the specimen after ensuring proper fasting.