Glucose Curve

Question 1

T/F: Transient, stress-induced hyperglycemia does change proteins such as fructosamine & glycosylated hemoglobin

Answer 1

False. It does not change the proteins listed above. These proteins are confirmatory if stress artifact is a concern.
Blood insulin level isn’t usually helpful.

Question 2

What must be present to confirm diabetes mellitus? (2)

Answer 2

1. Persistent hyperglycemia
2. Glucosuria

Question 3

Prolonged hyperglycemia causes ___ of proteins.
Glycosylated hemoglobin reflects blood glucose concentration over __-__ months.
Fructosamine reflects blood glucose over prior __-__ days.

Answer 3

a. Glycosylation
b. 3-4 months
c. 7-14 days

Question 4

After a diabetic is stable (hydrated & eating) for at least 7 days, what should be done?

Answer 4

A glucose curve performed to “fine tune” insulin therapy.

Question 5

How to board a diabetic patient: (4)

Answer 5

1. Minimize stress
2. Replicate insulin routine at home
3. Blood draw from catheter for glucose monitoring (gluc curve)
4. Bluetooth monitor
   - Can be used at home!

Question 6

Blood glucose in a diabetic patient should be maintained between __-__

Answer 6

150-300 range

Question 7

Goals of glucose curves: (6)

Answer 7

1. Determine duration of action of insulin
2. Determine high glucose & low glucose
3. Determine when low glucose occurs
4. Determine when the nadir (lowest level) occurs
5. Determine how low is the nadir
6. Determine the duration of one dose of insuling

Question 8

General approach to glucose curves (3)

Answer 8

1. Owner feeds animal & gives insulin in usual manner and usual schedule at home
2. Animal is brough to DVM & blood glucose is checked every 2-4hrs
3. Ideally glucose is monitored for 12hrs in dogs & 24hrs in cats

Question 9

After a glucose curve is performed, the DVM will evaluate & adjust insulin plan. Such as: (4)

Answer 9

1. Insulin type
2. Insulin dose
3. Insulin frequency
4. Feeding schedule

Question 10

Measuring insulin for suspected diabetes ___ helpful.
Insulin levels are measured to diagnose insulin-___ ___. Blood glucose should be ___ at the time of blood insulin level test.

Answer 10

1. Isn’t, is not
2. Insulin-Secreting tumors
3. <50

Question 11

Insulinoma
Etiology
Clinical signs (4)
Treatment (2)

Answer 11

1. Etiology
   - When the functional tumor of pancreatic B cells leading to excess secretion of insulin & chronic, severe hypoglycemia.
2. Signs
   - Weakness
   - Collapse
   - Disorientation
   - Seizures
3. Tx
   - Surgical removal
   - Medical support