Lab Investigation: Endocrine Disorders PDF

Lab interpretation: Endocrine disorders Ernieda Md Hatah, PhD Clinical Pharmacy Discipline Faculty of Pharmacy Universiti Kebangsaan Malaysia Endocrine system  Endocrine-related disorder Pancreas disorder Diabetes Mellitus Thyroid diso...

Lab interpretation: Endocrine disorders Ernieda Md Hatah, PhD Clinical Pharmacy Discipline Faculty of Pharmacy Universiti Kebangsaan Malaysia Endocrine system  Endocrine-related disorder Pancreas disorder Diabetes Mellitus Thyroid disorder Hyperthyroid Hypothyroid Adrenal disorder Adrenal insufficiency Cushing’s syndrome/ Cushing’s disease Diabetes Mellitus  Pancreas Pancreas is located deep in the abdomen Between stomach and spine Because of the position, it cant be palpable It is about 6 inches long It has two functions: Exocrine (release enzyme that helps with food digestion to the duodenum) Endocrine (release insulin and glucagon to the blood stream)  Common Pancreas Disorder Diabetes Characterized by hyperglycaemia (high sugar level in the blood) This is due to the abnormalities in carbohydrate, fat and protein metabolism cause by the defects in: insulin secretion insulin sensitivity or both Types of Diabetes: Diabetes Mellitus Type 1 (absolute deficiency of insulin) Diabetes Mellitus Type 2 (insulin deficiency with/without insulin resistance) Gestational Diabetes Mellitus (glucose intolerance during pregnancy)  Function of insulin Control blood glucose level by helping the cells (such as liver, muscle, fats) to take in glucose and used it for energy Help in storage of glucose https://www.youtube.com/watch?v=HJGjNTJgf48 Lab investigation: Diabetes Mellitus  Diagnosis **Conversion: A1c (mmol/mol) = [10.93 x A1c (%)] - 23.5 Diagnosis Diagnosis  Glucose monitoring Fasting serum glucose (Fasting Blood Sugar, FBS) (< 7.0 mmol/L) Also known as pre-prandial blood sugar Formed by digestion of carbohydrates and the conversion of glycogen by liver Serum sample is obtained after 10 to 14 hours of fasting Obtained before breakfast aft an overnight fast Elevated: in DM, liver disease-cirrhosis, obesity and pancreatitis, glucocorticosteroids, stress and diet Low level: extensive liver disease, overproduction of insulin, hypothyroidism and alcoholism  Glucose monitoring Random serum glucose (Random Blood Sugar, RBS) Also known and 2hrs post prandial Obtained at any time without fasting Normal < 11.1 mmol/L  Glucose monitoring Glucose tolerance test (GTT) To diagnose DM and GDM Patient fast for 10 to 16 hours then 75g of glucose given. Serial blood samples are obtained & serum glucose concentration determined Normal – serum blood glucose < 11.1 at 30,60, and 90 minutes