it is the rise of blood glucose level above 140 causes insulin in: diabetes mellitus (commonest...
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WAAD ALOTIBI
311200661
It is the rise of blood glucose Level above 140
CausesInsulin in:
Diabetes mellitus (commonest cause) surgical pancreatectomy
(removalof pancreas)Streptozotcin injection that destroy b-cells
pancreatitis and pancreatic cancer
HYPRERGLYCEMIA
1-ACTH and glucocorticoids: as in adrenal cortical tumors and cushing’s syndrome (b c reduce senstivity of tissues (me adipose tissue) to the offect of insulin on glucose uptake and utilization +
rate of gluconeogensis)
2-Adrenaline :as in emotionsstress and pheochromocytoma glycogenolysis in ms&liver+lipolvsis+inhibit insulin secretion)
3-TSHand thyroxine as in hyperthyroidism(b c thyroid H has diabetogenic action ( absorption of gluconse+gluconeogensis)
4- Pituitary growth hormone : as in acromegaly (b c chronic administrationof GH> glucose uptake in ms +fat tissue glucose > production by liver > insulin secrtion >>exhaustion of B
cell )
Dietary or alimentary high cardohydrate diet rich in simpl sugars drug-induced e g chronic use of corticosteroids
INCREAS ANTI-INSULIN HORMONES:
Normal:70-110mg/dl
Dm:>= 126mg/dl [%] on at least two occasion s
Impiared fasting glucose: fasting glucose(110-125)mg/dl
A risk factor for future diabetes
Normal:<180mg/dl
Dm: >200mg/dl in more than one occasion
1-FASTING BLOOD GLUCOSE(FBS) LEVEL:
2-random blood glucose level(RBS):
Normal:<140mg/dl
Dm:>200mg/dl even at one occasion
3-TWO HOUR POSTPRANDIAL TEST(PPS)
It measures the ability of body to utilize oral glucose dose
Measuring FBS [aftar 8-12h fasting ] and blood Glucose levels five times (every 30 min) over a period of 3 hours after ingestion of 75 grams glucose [1-1.5 gm/dl]of glucose. Urineis also
collected and glucose is estimated
4-THE ORAL GLUCOSE TOLERANCE TEST:
Normal FBS [70-110mg/dl]
Peak within 1h [not> renal threeshold [180mg/dl] The normal FBS isreached after 2-2.5 h [<140mg/dl]
No glucose or KB inany urine specimen In renal glycosuria,OGTT is normal
A- NORMAL RESPONSE
FBS is >110 and <126 2-hour glucose is >=140 but <200mg/dl
This is also considereda risk factor for future diabetes
B-IMPAIRED GLUCSE TOLERANCE [IGT}
A pregnant woman has any two of the dfollowing
AFBS>110mg/dl A1-hour glucose level< ;190mg/dl A2 hour glucose level <;165mg/dl
Or a 3hour glucose level of< ;145mg/dl
C- GESTATIONAL DIABETES :
FBG>=126mg/dl The peak is >180mg/dl
FBG is not reached after 2-3h[200mg/dl] Urine samples Always+ve for glucose whil
KB are+ve or –ve depending on the condition
D- DIABETIC GTT:
Normal FBS peak aftar 0.5-1 h and is 180mg/dl returns to normal aftar 2-2 5h. As in alimentary glucosuria
E-LAG CURVE
Easy inexpensive rabid and noninvasive below renal threshold 180mg/dl
HBA1c will tell ehat the diabetic’s blood sugar levels have been running for the past 2-3 months [life span of
RBCs normal HB A1c is 4-6,5
5.MEASUREMENT OF GLUCOSE IN URINE
6-measurement of glycoseylated hemoglobin glycated hb or hb a1c
Condensation product of glucose with serum albumin Estimate plasma glucose levels over (2-3 weeks) (half life
of alb ) Normal range (205-285 mmol/l)
7- MEASUREMENT OF SERUM FRUCTOSAMINE:
Detection in serum and urine : using (nitroprusside test ) acetone or acetoacetate nitroprusside to from violet color)
Acetest tablets or ketostix (strips)
:
It is an indicator of B-cell function and insulin secetory capacity in diabetic patients on insulin (doesnot cross react
with exogenous insulin)
-C-peptide is 0,9-4,2 ng/ml
Normal serum insulin 29-181 pm/l
8- MEASUREMENT OF KETONE BODIES :
9- measurement of c-peptide
10- measurement of insulin : by ELIZA
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