Term
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Definition
Glucose -> Pyruvate/lactate + ATP
Energy production |
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Term
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Definition
Glucose -> Glycogen
Storage of glucose as glycogen in liver and muscle |
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Term
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Definition
Glycogen -> Glucose
Release of glucose from glycogen or increase blood glucose |
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Term
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Definition
Amino acids Lactate Glycerol -> Glucose
Increase blood glucose when glycogen depleted |
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Term
|
Definition
b cells of pancreas
Increases cell membrane permeability to glucose; stimulates glycogenesis
dec's glucose level |
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Term
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Definition
Pancreatic D cells
Suppresses glucagon and insulin release
inc's glucose level |
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Term
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Definition
a cells of pancreas
Principal hormone to blood glucose
inc's glucose level |
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Term
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Definition
Adrenal medulla
Stimulates glycogenolysis; backup for glucagon
inc's glucose level |
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Term
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Definition
Adrenal cortex
Stimulates gluconeogenesis; antagonizes insulin
inc's glucose level |
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Term
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Definition
Anterior pituitary
Inhibits glucose uptake by cells; enhances release of cortisol & fatty acids
inc's glucose level |
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Term
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Definition
Anterior pituitary
Antagonizes insulin; mobilizes fatty acids; enhances transport of amino acids
inc's glucose level |
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Term
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Definition
Thyroid
Enhances glycogenolysis
inc's glucose level |
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Term
|
Definition
| Detects disorders of carbohydrate metabolism, mainly to diagnose DM and monitor DM therapy; best indicator of overall glucose homeostasis |
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Term
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Definition
| Simple glucose loading test, evaluated in conjunction with FBG to screen for DM |
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Term
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Definition
| Glucose loading test; most sensitive test to detect DM; abnormal results verified by repeat testing |
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Term
| 1-hr PP Gestational diabetes screen |
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Definition
| Simple glucose loading test, used to detect gestational diabetes at 24- to 28-week gestation; increased results should be confirmed by OGTT |
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Term
| Indications for Blood Glucose Screening |
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Definition
- All individuals at age 45 or older (x 3 years)
- Younger individuals with risk factors • Obesity
• First-degree relative with diabetes
• High-risk ethnic group
• Had baby >9 pounds or had gestational diabetes
• Hypertension
• HDL cholesterol < or triglycerides > 250
• Intermediate glucose measurements previously |
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Term
| Types of Diabetes Mellitus |
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Definition
- Type 1 diabetes
• Beta cells destroyed (no insulin produced) • Most cases are immune-mediated
• Formerly called “insulin-dependent”
- Type 2 diabetes
• Insulin resistance at tissue level (some insulin
produced)
• Relative insulin deficiency
• Formerly called “non-insulin-dependent”
- Specific disease types (see next slide)
- Gestational diabetes mellitus (GDM) |
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Term
|
Definition
• Genetic defects of beta cell function
• Genetic defects in insulin action
• Diseases affecting exocrine pancreas
• Endocrinopathies (involving other hormones)
• Drug/chemical induced
• Infections
• Autoimmune disorders |
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Term
| Diagnosis of Diabetes Mellitus |
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Definition
• Symptoms of diabetes plus random plasma glucose concentration >200 mg/dL
• Fasting plasma glucose >126 mg/dL
• Two-hour pp glucose >200 mg/dL with
loading dose of 75-g glucose
• Diagnosis made by presence of any one of the above criteria followed by confirmation on a subsequent day |
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Term
| Diabetes mellitus Fasting Blood (Serum) Glucose, Two-Hour Postprandial Glucose |
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Definition
>/=126 mg/dl
>/=200 mg/dl
Symptoms +
Random glucose >200 mg/dl |
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Term
| Normal Fasting Blood (Serum) Glucose, Two-Hour Postprandial Glucose |
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Definition
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Term
| Intermediate Fasting Blood (Serum) Glucose, Two-Hour Postprandial Glucose |
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Definition
>/=110 mg/dl <126 mg/dl
>/=140 mg/dl <200 mg/dl |
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Term
| Evaluating Test Results for Gestational Diabetes (24–28 weeks): Normal |
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Definition
|
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Term
Evaluating Test Results for Gestational Diabetes (24–28 weeks): Gestational diabetes screening test
(50 g glucose load) |
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Definition
| 1 hr PP >/= 140, pos screening, refer for OGTT |
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Term
Evaluating Test Results for Gestational Diabetes (24–28 weeks): Gestational giabetes
(OGTT with 100 g glucose load) |
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Definition
| FBG: <105, 1 hr PP: 1 hr > 190 2 hr > 165 3 hr >145. At least two values must meet criteria |
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Term
|
Definition
| Indicator of gluconeogenesis; helpful in differentiating between diabetic coma and insulin shock |
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Term
|
Definition
| Evaluation of fasting hypoglycemia and establish diagnosis of insulinoma |
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Term
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Definition
| Determines insulin secretion in presence of insulin antibodies and indicates surreptitious injection of insulin |
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Term
| Glycated hemoglobin or Hgb A1C |
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Definition
| Index of long-term glucose control (1- to 2-month period) |
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Term
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Definition
| Index of short-term glucose control (1–3 weeks) |
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Term
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Definition
• In presence of high levels of glucose, hemoglobin molecule irreversibly acquires a glucose on the beta chain
• 3–6% = normal
• Prolonged hyperglycemia, Hgb A1C up to
18–20%
• Indicates inadequate diabetic control in previous 3–5 weeks |
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Term
|
Definition
• Proinsulin → Insulin + C-peptide
• C-peptide—substance released by beta cells of pancreas in equal proportions to insulin
- Detects presence of insulin antibodies
- Detects surreptitious injection of insulin |
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Term
| Physician Office Lab (POL) Testing |
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Definition
• Glucostix
- Gives “ball park” estimate of glucose level
• Home glucose meters
- Cannot use for diagnosing diabetes
• Hemacue glucometer
- Can be used for diagnosing diabetes
• Automated chemistry instruments
- Not always practical for POL |
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Term
|
Definition
• BMP = Na+, K+, Cl-, CO2, BUN, Creatinine, Glucose, and Calcium
• SOAP note abbreviation for BMP:
[image] |
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Term
|
Definition
• Anion gap = difference between measured cations and measured anions
Na–(Cl+CO2)=8–16meq/l
• Increased gap = retention of one or more unmeasured anions (lactic acid, ketoacids, proteins–renal failure, salicylate poisoning)
• Decreased gap = hypoalbuminemia or retention of unmeasured cations
• Body must maintain electrical neutrality |
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Term
|
Definition
solute concentration in plasma or serum; determines distribution of water between intra- and extracellular compartments
• 1.86(Na) + Glucose/18 + BUN/2.8 • Normal = 275 – 295 mOsm/kg
• Useful in diagnosing poisonings (alcohol, salicylate, methanol)
• Osmol gap = measured – calculated • >10 = poisoning; <10 = normal |
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Term
| Correcting Na+ for Hyperglycemia |
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Definition
• Factitious hyponatremia in hyperglycemia • Correction: For every 100 mg/dL glucose
over 100 mg/dL, add 1.8 mg/dL to sodium
• Example:
• Sodium = 133 meq/L
• Glucose = 402 mg/dL
• Corrected Na+ = 1.8 x 3 = 5.4 meq/L
• 133 + 5.4 = 138 meq/L (corrected value) |
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