PHAR3818 Lecture Notes - Lecture 4: Glucose Tolerance Test, Glucose Test, Glycated Hemoglobin
23 Jul 2018
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Presented to gp practice feeling tired and run down, 8kg weight loss over 6 weeks. Diabetes clinical cases: has polydipsia, polyuria and blurred vision. Bp - 90/60 mmhg: dry tongue, reduced tissue turgor. Blood glucose = 25 mmol/l: urinary dipstick ketones = ++++ Glucose + protein glycated protein change in property (e. g. increased crosslinking) Eventually form advanced glycosylation end products (ages: hba1c - non-enzymatic glycation product of haemoglobin to plasma glucose. Pancreatic beta cell destruction, leading to absolute insulin deficiency. Aim of insulin treatment is to replicate physiological insulin excursions to normalize glucose levels. Therefore, ideally patients with type 1 diabetes should have basal & bolus insulin. Basal insulin - preferably peakless flat and 24 hour insulin. Bolus insulin - preferably works immediately when carbohydrate is ingested and wears off when the food is digested i. e. less risk of hypoglycaemia highly effective and 2-3 hour insulin. Insulin is largely classified by its onset/peak, duration of action, and molecular structures.
