Lab 2 Assessment of Blood Glucose and Oral Glucose Tolerance Tests PDF

Assessment of blood glucose & oral glucose tolerance tests  Outline 3-Causes of 1-Introduction 2-Hyperglycemia hypoglycemia 4- Diagnosis O...

Assessment of blood glucose & oral glucose tolerance tests  Outline 3-Causes of 1-Introduction 2-Hyperglycemia hypoglycemia 4- Diagnosis OGTT curve 6-Cases Glycated hemoglobin  1-Introduction Carbohydrates: Are biomolecules consisting of (C), (H) and (O) atoms, usually with a hydrogen–oxygen ratio of 2:1 (as in water). Carbohydrates' main role is to provide energy. Glucose is the main carbohydrate used for energy production.  Glucose Homeostasis Blood [glucose] is maintained within a range below which is hypoglycemia, and above which is hyperglycemia. Homeostasis can be maintained by: The potential loss in urine if the renal threshold is exceeded. (Renal threshold = 180mg%) Major amount of glucose from diet is delivered to liver via the portal circulation to be oxidized and/or converted to glycogen to be used as a source of energy under fasting conditions. Glucose in excess of these requirements is partly converted by the liver to FA and TG, which are then incorporated into (VLDLs) and transported to adipose tissue stores.  Glucose Homeostasis Insulin: lowers blood glucose level. Insulin formation: Pre-proinsulin (A-chain and B-chain connected by C peptide, packaged in secretory granules in Golgi apparatus) → Removal of signal peptide to form Proinsulin → Removal of C-peptide to form Insulin. Anti-Insulin Hormones: Raises blood glucose level. ✓ Glucagon ✓ Adrenaline / Nor-adrenaline ✓ Growth Hormone ✓ Glucocorticoids ✓ Thyroxine  2- Hyperglycemia It is a condition in which glucose level increases in blood. Signs and Symptoms A-Acute signs and symptoms ▪ Polyuria ❖ If hyperglycemia goes untreated, ▪ polydipsia (ketoacidosis) occur: ▪ Polyphagia ▪ Fruity urine and smelling breath ▪ Weight change ▪ Dry mouth ▪ Fatigue and Headache ▪ Nausea and vomiting ▪ Weakness ▪ Confusion ▪ Coma Long term complications of hyperglycemia  Diabetes Mellitus Type 1: Insulin dependant Diabetes Mellitus Type 2: Non- Insulin dependant 1-Types of Diabetes Causes of Hyperglycemia Bronze Diabetes: Abnormal storage of excess Iron in Beta cells of Pancreas 2-Cushing's syndrome Gestational Diabetes: Onset of diabetes during pregnancy 3-Unusual hormone-secreting tumours  3- Causes of hypoglycemia 2- Accidental or deliberate 1- Insulinoma: overdose of insulin: A small benign adenoma of the Giving rise to hypoglycemia, can pancreatic islets that secretes therefore be distinguished from inappropriate amounts of insulinoma by measuring both insulin. plasma [insulin] and plasma [C Most patients develop peptide]. symptomatic hypoglycemia Exogenous insulin contains little when blood sugar level drops or no C peptide. below 60 mg/dl. Immediate intervention is required for hypoglycemia. Insulinoma can be diagnosed by: The fasting plasma insulin conc. and C-peptide level are inappropriately high in relation to the low plasma glucose level.  1- Random (up to 200 mg/dl) borderline. 1- Random Blood Glucose 2- Fasting (70-110 Glucose normal range: mg/dl), then up to 150 2- Fasting Blood Glucose is borderline. 5- Glucose tests Test (after 8 hours fasting) 3- Postprandial (80-120 mg/dl), then up to 200 is borderline. 3- Post prandial (after 2 hours from a meal) 4- Risk of hypoglycemia (