Diabetes Reference Ranges and Metabolism

Study Notes

Gestational Diabetes Reference Ranges

Fasting glucose ≥ 92 mg/dL
1-hour glucose ≥ 180 mg/dL
2-hour glucose ≥ 153 mg/dL

Type 1 Diabetes Reference Ranges

Fasting blood glucose > 126 mg/dL

Type 2 Diabetes Reference Ranges

Fasting glucose ≥ 126 mg/dL
Random glucose ≥ 200 mg/dL

Lactate Reference Range

0.5–2.2 mmol/L

Microalbumin Reference Range

< 30 mg/24 hours in urine

Abnormal Metabolic Relationships in Insulin-Dependent Individuals

Lack of insulin prevents glucose uptake
Increased fatty acid oxidation and ketone production (acetoacetate, beta-hydroxybutyrate)
Ketoacidosis can occur
Impaired glucose metabolism leads to increased lactate due to anaerobic glycolysis

Causes of Hypoglycemia

Insulin overuse
Alcohol consumption
Pancreatic islet cell tumors
Fasting
Postprandial hypoglycemia
Medications

Detecting Ketones and Microalbumin

Ketones in serum/urine are detected using nitroprusside tests (Acetest or Ketodiastix)
Microalbumin in urine is measured by immunoassays or albumin-to-creatinine ratio

POCT Glucose Methods

Portable meters utilize glucose oxidase or hexokinase methods
Whole blood is used, resulting in 10-15% lower values compared to plasma or serum

Pros and Cons of Fructosamine Test

Pros: Reflects short-term glucose control (2-3 weeks)
Cons: Affected by protein metabolism disorders, less precise than HbA1c

Pyruvate and Lactate Relationship

Pyruvate is converted to lactate under anaerobic conditions
Increased lactate-to-pyruvate ratio (>35) suggests hypoxia
Low ratio (<10) indicates mitochondrial dysfunction or pyruvate deficiency

Description

Test your knowledge on diabetes reference ranges and related metabolic conditions. This quiz covers gestational, type 1, and type 2 diabetes, along with lactate and microalbumin reference values. Understand complications like ketoacidosis and causes of hypoglycemia.