CLINICAL SIGNIFICANCE OF CARBOHYDRATES Flashcards
LECTURE
Results from an IMBALANCE between GLUCOSE UTILIZATION and PRODUCTION
Hypoglycemia
Categories of Hypoglycemia:
-Triggered by Autonomic Nervous System
-Tremulousness, Palpitations, and Anxiety are Catecholamine Mediated
-Diaphoresis, Hunger, and Paresthesia are related to Acetylcholine release
Neurogenic Symptoms
Categories of Hypoglycemia:
-Due to diminished Glucose supply to the CNS
-Dizziness, Tingling, Difficulty concentrating, Blurred vision, Confusion, Behavioral changes, Seizure, and Coma.
Neuroglycopenic Symptoms
Can be diagnosed by demonstrating that insulin secretion is not suppressed normally when the individual develops Hypoglycemia
Pancreatic Hyperinsulinemic Hypoglycemia
Measurements to Determine the Correct Diagnosis of Hypoglycemia
Insulin
C-Peptide
Pro-insulin
Insulin and Insulin Autoantibodies
B-hydroxybutyrate
Drugs
Pro-insulin is converted to Insulin by _
C-Peptide
Cause dysregulation in insulin secretion and hypoglycemia
Congenital Hyperinsulinism
Measured in hypoglycemic states to help identify the cause of the Hypoglycemia
C-Peptide levels
High Insulin and C-Peptide levels indicates
Insulinoma
Congenital Hyperinsulinism
High Insulin and Low C-Peptide levels indicates
Hypoglycemia from injected or Exogenous Insulin
An important tool in assessing patients with episodes suggestive of low plasma Glucose levels
Whipple’s Triad
Whipple’s Triad consists of:
1.Symptoms consistent with Hypoglycemia
2. Documented Low Plasma Glucose Level
3. Relief of Symptoms with Correction of Hypoglycemia
Blood should be drawn every _ to measure glucose, C-Peptide, insulin, and pro-insulin, and ketone bodies (B-hydroxybutyrate)
6 hours
When plasma glucose is _ sampling should be performed every 1 to 2 hours and the testing is usually up to 3 days
<60 mg/dL
The fasting procedure should be stopped when the plasma glucose decreases to _
<45 mg/dL
The most common non-iatrogenic cause of Hypoglycemia in children between 18 months and 5 years of age
These patients have RECURRENT MORNING HYPOGLYCEMIA
Ketonic Hypoglycemia
it is characterized by a plasma (or serum) glucose concentration low enough to cause symptoms and/or signs, including impairment of brain function
FACTITIOUS HYPOGLYCEMIA
Clinical Hypoglycemia
It is characterized by an increase in blood glucose concentration. It is toxic to beta-cell function and impairs insulin secretion
Hyperglycemia
A group of diseases in which BLOOD GLUCOSE LEVELS ARE ELEVATED
The most common set of disorders of CARBOHYDRATE METABOLISM
Diabetes Mellitus
Diabetes Mellitus that can cause nerve damage
Diabetic Neuropathy
Diagnostic Criteria For Diabetic Mellitus:
Using a method that is NGSP certified and standardized to the DCCT assay
HbA1C (Glycosylated Hemoglobin)
Diagnostic Criteria For Diabetic Mellitus:
Greater than or equal to 126 mg/dL (greater than or equal to (7.0 mmol/L)
Fasting Plasma Glucose
Diagnostic Criteria For Diabetic Mellitus:
Greater than or equal to 200 mg/dL (greater than or equal to 11.1 mmol/L) during an OGTT
2-H Plasma Glucose
Diagnostic Criteria For Diabetic Mellitus:
Greater than or equal to 200 mg/dL (greater than or equal to 11.1 mmol/L) plus symptoms of diabetes
Random Plasma Glucose
