Glucose Serum Levels-The Methodology and Procedures

Glucose Serum Levels-Glucose is made up of carbohydrates in food and stored as glycogen in the liver and skeletal muscle. Glucose levels are affected by the 3 kinds of hormones produced by the pancreas gland. Hormones: insulin, glucagon, and somatostatin.

Glucose Serum Levels

Insulin is produced by then β-cells, metabolic picture dominates. These hormones regulate the use of glucose through many ways: increasing the intake of potassium and glucose into most cells; stimulates the synthesis of glycogen in the liver and muscles; drive change glucose into fatty acids and triglycerides; and increases protein synthesis, glucose metabolism residue portion of. Overall, the effect of this hormone is to encourage energy storage and boost the use of glucose.

Glucagon is produced by α cells, increase protein synthesis and stimulates glikogenolisis (conversion of glycogen reserves into glucose) in the liver; he reverses the effects of insulin. Somatostatin is produced by the cells of the delta, inhibiting secretion of glucagon and insulin; This hormone also inhibits growth hormone and hormone pituitary hormones that encourage the secretion of adrenal and thyroid.

Moments after eating or drinking, an increase in blood sugar levels, stimulates the pancreas produces insulin to prevent blood sugar levels rise further. Insulin inserts sugar into the cells so that it can generate energy or stored as energy reserves. The presence of abnormalities in insulin secretion, insulin work, or a combination of both, will have an effect on the concentration of glucose in the blood.

A decrease in blood glucose levels (hypoglycemia) occurs due to the intake of foods that are not strong or blood containing too much insulin. Increased levels of blood glucose (hyperglycemia) occurs if insufficient circulating insulin or may not function properly; This State is called diabetes mellitus. If plasma or serum glucose levels during (anytime, without considering the last meal) of ≥ 200 mg/dl, glucose levels, fasting serum/plasma that reaches > 126 mg/dl, serum/plasma and glucose 2 hours after a meal (post prandial) ≥ 200 mg/dl is usually be an indication of the onset of diabetes mellitus.

Fasting glucose levels give the best clues about the overall glucose homeostasis, and most routine measurements must be made on a sample of fasting. Circumstances that can affect glucose levels (e.g., diabetesmellitus, obesity, akromegali, severe liver disease, etc.) reflects abnormalities in various glucose control mechanisms.

The postprandial blood glucose test is usually performed to test the response of a high carbohydrate intake against sufferers 2 hours after a meal (breakfast or lunch).

For cases of Hyperglycemia or hypoglycemia even obscure, usually performed oral glucose tolerance tests (TTGO). TTG oral physiological variables affected by many and became the subject of different diagnostic interpretation.The Intravenous glucose tolerance test is rarely indicated for the purpose of diagnosis.

PROCEDURE 

 

Type of specimen

First, glucose measurement is done using a sample of the full blood (whole blood), but almost all laboratories perform measurements of glucose levels with serum samples. The serum has a higher water content than full, so that blood serum can dissolve more glucose. To convert, multiply the complete blood glucose values obtained with 1.15 to produce serum or plasma glucose levels.

The collection of blood in the tubes for clot serum analysis allows the occurrence of metabolism of glucose in the sample by blood cells until the separation occurs via (centrifugation). A high number of blood cells can lead to excessive Glycolysis which decreased glucose levels. To prevent glycolysis, the serum should be separated from the blood cells.

The temperature of the environment where the blood is stored before being examined undertook to affect the rate of Glycolysis. At room temperature, a decrease in the glucose levels occurred 1-2% per hour. While the temperature of the refrigerator, glucose remains stable dive for a few hours in the blood.

The addition of sodium fluoride (NaF) in a blood sample can inhibit Glycolysis so that glucose levels be maintained even at the temperature of the room.

The collection of specimens

The taking of blood should be done on the opposite arm with hose installation armIV. The taking of the blood arm-mounted hose IV can be done as long as the flow hose is stopped at least for 5 minutes and the arm is lifted to drain liquids infuse away from the vein-vein. 10% contamination by liquid dextrose 5% (D5W) can increase the levels of glucose in the sample of 500 mg/dl or more.

Arteries, veins, and capillaries have equivalent levels of glucose in a State of fasting, while after meals venous levels, lower than the arteries or capillaries.

To test blood glucose fasting, sufferers were asked to fast for 10 hours from the night before the blood is drawn (e.g. The fast hours starting 9 p.m.). During fasting sufferers should not perform strenuous physical activity, should not be allowed to smoke, and keep drinking water white. The morning after fasting (e.g. hours, 8 am), venous blood is taken 3-5 sufferers ml collected in the tube color red (no anticoagulant) or in the blue tube (containing NaF).NAF is used to prevent Glycolysis which may affect the results of the laboratory. Sufferers were asked to eat and drink as usual, then fast again for 2 hours. During fasting sufferers should not perform strenuous physical activity, should not be allowed to smoke, and keep drinking water white To post prandial glucose test, blood vein taken sufferers as much as 3-5 ml of exactly two hours after eating, and collected in a red tube (without anticoagulants) or in a yellow tube (containing NaF). The blood that had acquired disentrifus, then plasma or serum separated and checked the levels of glucose.

To test blood glucose during or random/random, sufferers don't need fast and can be done at any time.

Methodology

Glucose Serum Levels

First, glucose is checked by utilizing the nature of non-specific reduction of glucose in a reaction with an indicator of material gain or changes color if it is reduced. Because many types of reducing another in blood that can react positively, then by this method could be higher glucose levels 5-15 mg/dl.

Now, the measurement of glucose using anzymatic method that is more specific toglucose. This method generally uses the enzyme glucose oxidase or heksokinase, which work only on glucose and other sugars and not on reducing other materials. Enzymatic changes glucose into products is calculated based on the reaction colour change (kolorimetri) as the last of a series of chemical reactions, or based on oxygen consumption on an oxygen detector electrode. Chemistry analyzer (chemical Analyzer machine) can calculate the concentration of glucose in respect of only a few minutes.

Outside the laboratory, now widely available range of glucose monitors private brand that can be used to measure the blood glucose levels of thrust in the fingertips. This tool is quite useful to know the blood glucose levels and to adjust therapy. However, these tools have a shortage where the measurement results are affected by the levels of serum protein and also the hematokrit; low levels of hematokrit can increase in artificial blood glucose levels, and vice versa (similar effect also applies to low serum protein or high). Therefore, the sufferer should periodically compare the results measuring prod with the measurement of the glucose laboratory clinic (raw gold) to estimate the possibility of interference and the physiological function of fluctuations of their tools.

THE VALUE OF THE REFERENCE

• Blood sugar during

Adults: Serum and plasma: up to 140 mg/dl; Full blood: up to 120 mg/dl

Children: up to 120 mg/dl

ELDERLY: Serum and plasma: up to 160 mg/dl; Darahlengkap: up to 140 mg/dl.

• Fasting blood Sugar

Adults: Serum and plasma: 70 – 110 mg/dl; Full blood: 60 – 100 mg/dl; The value of panic: less than 40 mg/dl and > 700 mg/dl

Children: newborn: 30 – 80 mg/dl; Children: 60 – 100 mg/dl

ELDERLY: 70 – 120 mg/dl.

• Postprandial blood glucose

Adults: Serum and plasma: up to 140 mg/dl; Full blood: up to 120 mg/dl

Children: up to 120 mg/dl

ELDERLY: Serum and plasma: up to 160 mg/dl; Full blood: up to 140 mg/dl.

 CLINICAL PROBLEMS

INCREASED LEVELS (hyperglycaemia): diabetes mellitus, diabetic acidosis, hyperactivity of the adrenal glands (Chusing syndrome), akromegali, hyperthyroidism, obesity(obesity), feokromositoma, severe liver disease, acute stress reaction (physical or emotions), shock, seizures, acute injury collisions, MCI, Burns, infections, kidney failure,hypothermia, activities, acute pancreatitis, pancreatic cancer, CHF, post gastrectomysyndrome (dumping syndrome), major surgery. The influence of the drug: ACTH; Cortisone; Diuretics (hidroklorotiazid, furosemid, etakrinat acid); anesthesia, medications of l-dopa.

LEVELS (hypoglycaemia): hypoglycemic reactions (excess insulin), hipofungsi adrenalcortex (Addison's disease), hipopituitarisme, galaktosemia, formation of ectopic insulin of tumors/cancer (stomach, liver, lungs), malnutrition, ingestion acute alcoholism, liver disease, liver cirrhosis, some disease build up glycogen, Hypoglycemia is functional (activities), hereditary fructose intolerance, eritroblastosis fetalis, hiperinsulinisme. The influence of the drug: insulin excess, salicylate, antituberkulosis drugs.

Factors that can Affect the results of the laboratory

• Medication (cortisone, tiazid, "the loop" diuretic) can cause an increase in blood sugar levels.

• Trauma, stress can cause an increase in blood sugarlevels.

• Smoking can increase serum blood sugar levels.

• Activities that weight before laboratory test done can lower blood sugar levels.

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