home blood glucose test glucometer 5
TRANSCRIPT
S.SUNITHA THENDRAL ‘06
URINE "GLUCOSE"◦ lacks sensitivity = positivity in disease◦ poor specificity = negativity in health
Problems◦ renal threshold variable 6 to 15 mmol/L◦ interferences : Clinitest / Glucose oxidase strips
IF URINE TEST POSITIVE A CONFIRMATORY BLOOD TEST
IS NEEDED
Diagnosis◦ Patient is symptomatic plus
Casual plasma glucose (non-fasting) is 200 mg/dl OR
Fasting plasma glucose of 126 mg/dl or higher OR
Two hour plasma glucose level of 200 mg/dl or greater during an oral glucose tolerance test
A venous blood sample will be collected for the determination of fasting glucose
Load of 75g of glucose is ingested within 5 min
Blood samples will be collected at timed intervals (30min, 60min, 120min) for the determination of glucose
Plasma glucose (mmol/L) 0 min
120 min
Non diabetic < 6.1 < 7.8
Impaired glucose tolerance 6.1 - 6.9 >7.8 - 11.1
Diabetic > 7.0 > 11.1
HbA1c is stable glycosylated
hemoglobin Its percentage concentration
indicates cumulative glucose exposure
A good indicator of blood glucose control. Gives a % that indicates control over the
preceding 2-3 months. Performed 2 times a year. A hemoglobin of 6% indicates good control
and level >8% indicates action is needed.
Lowering HbA1C Reduces Risk of Complications
TO PREVENT TIMELY EMERGENCIES
OF HYPO AND HYPER GLYCEMIA
AMOUNT OF INSULIN TO BE USED BEFORE MEALS
EFFECT OF DIET AND EXERCISE ON BLD GLUCOSE
NEW GLUCOMETER ARE ATACHED WITH INSULIN PUMPS TO
MONITER THE AMOUNT OF INSULIN TO BE RELEASED
COMPLICATIONS; INFECTIONS IF FINGERS NOT CLEANED
PROPERLY
HARDENING OF SKIN IF REPEATEDLY
PRICKED
MICRO ALBUMINURIA
SERUM CREATININE (NORMAL <_ 1)
RELATIVE :
24 HR PROTEIN IN URINE
Blood levels of phosphorus, calcium, bicarbonate, and potassium
Hemoglobin
Hematocrit
Protein electrophoresis - urine
Red blood cell (RBC) count
HIGH BLOOD PRESSURE
Visual acuity testing;ABILITY OF EYE TO FOCUS
SLIT LAMP EXAMINATION; CATARACT AND
CHANGES IN ETINA
GONIOSCOPY;DRAIN ANGLE - GLAUCOMA
FLUORESCEIN ANGIOGRAM; LEAKING BLD VESSEL
IN RETINA(DISTORTED VISION)
People with type 1 diabetes who are age 10 and older
should have an eye exam within 3 to 5 years after diabetes
is diagnosed and then every year
People with type 2 diabetes should have an exam as soon
as diabetes is diagnosed and then every year
Assess symptoms - muscle weakness, muscle cramps, prickling, numbness or pain, vomiting, diarrhea, poor bladder control
Comprehensive foot exam ◦ Skin sensation and skin integrity◦ Quantitative Sensory Testing (QST)◦ X-ray
Nerve conduction studies Electromyographic examination (EMG) Ultrasound
NORMAL RANGE
ANALYTE NORMAL VALUE (MG/DL)
TOTAL PLAMA LIPID 400 – 600
TOTL CHOLESTROL 150 – 200
HDL 30 – 75
LDL 80 -175
TRIGLYCERIDE 40 -150
PHOSPHOLIPID 150 -200
FREE FATTY ACID 10 - 20
SERUM CHOLESTROL <220 MG/DL LDL >160MG/DL HDL<35 MG/DL
WHY DM HAS HIGH RISK FOR MI? LACK OF INSULIN ACTIVATES LIPASE GLYCATION OF LDL INCREASES ITS HALF
LIFE