Professional Documents
Culture Documents
Glucose comes from carbohydrate foods. It is the main source of energy used by the
body.
Brain cells are very dependant on glucose for their energy supply: hypoglycemia is
likely to impair cerebral function. This is because they cannot:
• Synthesize glucose,
• Extract enough glucose from extracellular fluid at low concentrations for their
metabolic needs, because entry into brain cells is not facilitated by insulin.
Normally the plasma glucose concentration remains between about 80 and 200
mg/dl (4.5 and 11 mmol/L) despite the intermittent load entering the body from the GIT. The
maintenance of plasma glucose concentrations below about 200 mg/dl minimizes loss from
the body as well as providing the optimal supply to the brain. Renal tubular cells reabsorb
almost all the glucose filtered by the glomeruli and urinary glucose concentration is normally
too low to be detected by the usual tests, even after a carbohydrate meal. Significant
glycosuria only occurs if the plasma glucose concentration exceeds about 200 mg/dl – the
‘renal threshold’.
• Fasting blood sugar (FBS) measures blood glucose after fasting for at least 8 hours. It
often is the first test done to check for diabetes.
• 2-hour postprandial blood sugar measures blood glucose exactly 2 hours after eating
a meal. Its also called Random Blood Sugar (RBS.)
• Oral glucose tolerance test is used to diagnose prediabetes and diabetes. An oral
glucose tolerance test is a series of blood glucose measurements taken after drinking a
sweet liquid that contains glucose. This test is commonly used to diagnose diabetes that
occurs during pregnancy (gestational diabetes).
In normal individual following a meal, there is a temporary rise in the blood glucose level
with a return to fasting level within 2-3 hours. Glucose tolerance test determines the degree
and duration of hyperglycemia after an oral or intravenous administration of a known
quantity of glucose.
PROCEDURE:
• The test is best carried out in the morning after an overnight fasting.
• Blood is taken for the determination of fasting blood glucose and a specimen of urine
is collected.
• This is best followed by about 50-100ml of water which takes away the sweet taste
and lessens the risk of vomiting.
• Blood for the estimation of blood glucose is taken at half hourly intervals, for two and
half hours after the glucose solution has been drunk
• O-toluidine method
O-toluidine method is simple and specific and most widely used method for the
determination of blood glucose.
Why It Is Done
1. Normal Response
• Initial zero hour fasting blood glucose is within the normal range
and the maximum blood glucose value reaches either half-hour or 1
hour after taking the glucose.
• The blood glucose then returns rapidly to the normal fasting limit
which often reaches in 1 and a half hours and almost always at 2
hours.
By then, it should be below 120mg%
b. Renal Glycosuria;
• The curve is normal but one or more samples of urine contain glucose.
• When the blood levels are elevated, the glomerular filtrate contains more
glucose than can be absorbed, so the excess passes into the urine to produce
glycosuria.
• Normally glycosuria occurs when venous blood concentration exceeds 180-
200mg%. This is termed as renal threshold for glucose.
• This type of curve is harmless and patients are not likely to develop diabetes.
GLYCATED HEMOGLOBIN
This can be utilized as an assessment of glycemic control in a patient with known diabetes,
but is not sufficiently sensitive to make a diagnosis of diabetes and is usually within the
normal range in patients with impaired glucose tolerance
HYPERGLYCEMIA
• Other causes include infectious diseases and intra cranial diseases such as
meningitis, encephalitis, tumours and hemorrhage.
HYPOGLYCEMIA
Causes
Types
• “Pre-diabetes” is a condition in which blood glucose levels are higher than normal but
not yet diabetic. People with pre-diabetes are at increased risk for developing type 2
diabetes, heart disease and stroke. This condition are as follows:
• Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycaemia (IFG) are
intermediate conditions in the transition between normality and diabetes.
People with IGT or IFG are at high risk of progressing to type 2 diabetes,
although this is not inevitable.
Signs and Symptoms
• Weight loss
• Blurred Vision
Type 2 symptoms
• Symptoms may be similar to those of Type 1 diabetes, but are often less
marked. As a result, the disease may be diagnosed several years after onset,
once complications have already arisen.
• Until recently, this type of diabetes was seen only in adults but it is now also
occurring in obese children.
Gestational Diabetes
PROVIDED REAGENTS:
GOD_____________________ ≥ 10KU/l
POD_____________________ ≥ 1KU/l
4-AP_____________________ 0.5Mm
Hydroxybenzoate___________12mM
Provided Reagents: stable in refrigerator (2-10 0C). Do not expose to high temperature for
longer periods of time.
INSTABILITY OR DETERIORATION OF REAGENTS:
During its use, the reagent may develop a light pink coloration which does not affect its
performance as long as Blank is processed for each determination lot and a standard
periodically. Discard when the Blank readings are higher than 0.160 O.D. or the standard
readings are abnormally low.
a. Collection: Obtain serum in the usual way or plasma collected with ordinary anti-
coagulant. Tests can also be performed on other biological fluids such as CSF. The
test can be performed on capillary blood when venous blood cannot be drawn, or in
case of an emergency.
b. Additives: If plasma is used as sample, it is recommended to use Weiner labs’
Anticoagulant G or heparin.
c. Known Interfering substances: Sera or plasma with visible or intense hemolysis
should be deprotienized.
No interferences are observed from bilirubin up to 100mg/ dl,
triglycerides up to 5g/ L, and hemoglobin up to 0.35 g/ dl.
REQUIRED MATERIAL:
• Spectrophotometer.
• Micropipettes and pipettes for measuring the stated volumes.
• Spectrophotometer cuvettes or Photo colorimeter tubes.
• Water bath at 37 0C.
• Watch or timer.
ASSAY CONDITIONS:
B S U
Standard - 10 µl -
Sample - - 10 µl
Final reaction color is stable for 30 min, thus absorbance should be read within that period.
× Concentration of standard
O.D. of standard