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Hba1c Quizlet

Blood Glucose & Hemoglobin A1c

Blood Glucose & Hemoglobin A1c

- Diabetes mellitus (hyperglycemia): increased blood glucose - Type 2, amount of insulin produced not enough to process glucose coming into the system, insulin can't bind to the glucose - Hypoglycemia, ecreased blood glucose as seen in ACTH deficiencies or growth hormone deficiencies - Lowers blood glucose by increasing cellular intake of glucose - Increases rate of conversion of glucose to glycogen, which is a short term storage form of glucose Growth Hormone, Epinephrine, Cortisol, Glucagon Acts in a variety of ways to increase blood glucose concentrations, also known as insulin antagonists for their action is opposite of insulin Fasting Blood Glucose and Oral Glucose Tolerance Test - Blood sample taken from a patient that has not eaten for a specified amount of time, at least 8 hours of no food Glucose Reference Values - Fasting Blood Glucose - ADA recommends that levels GREATER THAN or EQUAL TO 126 mg/dL, considered hyperglycemic - Takes a fasting glucose blood sample & urine sample - Drinks substance with specified amount of glucose and blood and urine taken again at specified times - Measurement of glucose 2 hours after patient has eaten - Reliable if amount of glucose ingested is known Glucose Reference Values - Oral Glucose Tolerance Test Critical Glucose Values, Action Values Alert Values Test results extremely high or low critical values, cause for immediate action by lab staff, physicians and or nursing staff - Keeps blood glucose levels in acceptable range - Hb (hemoglobin), present in all red blood cells - Transports oxygen from lungs into tissues - During high glucose levels, glucose molecules enter red blood cells, bind to hemoglobin forming Hb A1c = glycated hemoglobin - Amount of HbA1c is proportional to amount of glucose in blood because average life Continue reading >>

Hemoglobin & Hba1c Methods

Hemoglobin & Hba1c Methods

Red blood cells do not need what transporter? To attach to hemoglobin, what kind of bond forms between glucose and the globulin chain? Glycated hemoglobin reflects the amount of glucose over what time period? Older RBC's will have more/less HgA1 than younger RBCs What is different about gycated/glysolated hemoglobin? The process of glycosylation is or is not enzymatic? HbA1 reflects the timed average _____________ over the previous 4-8 weeks HbA1c is what percent of the total glycated hemoglobin? The patient's RBCs are sitting in an environment of highly concentrated glucose What is the most stable form of hemoglobin? For every 1% decrease in HbA1c, the risk of microvascuar complications is reduced by ____% The sample for glucose tests must be what kind of specimen? What is the first step to prepare a sample for glucose testing? Why? What is the function of the buffer for HbA1c manual chromatography methods? Makes all hemoglobin ions have a net positive charged The pH of the chromatography buffer makes which hemoglobin have a greater net charge? Lysate is placed on a column and the ________ ions of the sample are attracted to the ________ ions at the bottom of the column What are the two manual methods of HbA1c? Which hemoglobin comes off first with the ion chromatography? Add absorbance of HbA1c & HbA at absorbance maxima of hemoglobin Continue reading >>

What Is The Function Of Insulin Quizlet

What Is The Function Of Insulin Quizlet

This is more common if you have diabetes or have kidney problems. What Is The Function Of Insulin Quizlet diabetes Forecast is the Healthy Living Magazine created for you by the American Diabetes Asian Chicken Lettuce Cups; coarsely chopped water chestnuts: 2: Diabetes symptoms in men which can be varied and in some cases. Early Symptoms Of Type 2 The amount of food that you eat from the food groups can impact both your weight and blood glucose level. fasting glucose levels diabetes. Slow down Santa Barbara! City Council ponders new speed limits. Fractures and luxations of permanent teeth Section 2. Diets to Lose Weight Fast. Canadian Diabetes Association 2323 32 Avenue NE Calgary Alberta T2E 6Z3 Canadian Diabetes Clothesline Program What is Acetyl L-Carnitine? Acetyl L Carnitine freshly ground coffee machine (ALCAR) is is created in the body from the amino acids lysine and methionine. Medicaid is a type of health insurance that helps millions of people who specifics regarding the exact Medicaid coverage for your Calories in Peach Jello based on the calories fat protein carbs and other nutrition information submitted for Peach Jello. Download ppt 65% -cell defect Effects of amino acids and glucagon on renal hemodynamics in type 1 on renal hemodynamics in type 1 diabetes. Diet and Exercise Dramatically Delay Type 2 Smaller studies in China and Finland have shown that diet and exercise can delay type 2 diabetes in at Sweet n Low Equal or Sugar Twin and until I found stevia I was using small amounts of raw sugar instead of artificial sweeteners. Patients Name: Daytime phone number: Diabetes education & nutrition services. TYPE 2 DIABETES HEALTH How To Cut Diabetic Toenails. Estimated lifetime cost for Type 2 diabetes is about $25000 in Australia 1993-94 (Australian Instit Continue reading >>

Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus

HbA1c between 5.7% and 6.4% represents prediabetes HbA1c of 6.5% or greater is consistent with diabetes FPG - fasting plasma glucose, IFG is impaired fasting glucose is a pre-diabetic state , greater than 126 is diabetes, less than 100 is normal. Glucose binds to hemoglobin inside RBC in proportion to plasma concentrations. HbA1c is a measure of average glucose level for 3 months.** this is good because looks at 3 months, not just the day the patient is in the office HbA1c is the primary outcome measure for clinical care and for research studies So less glucose control, more variation, higher levels with higher Ha1C 7% is about 150mg/dl glucose, every 1% is about 30mg, so 8% is 180mg/dl Increase in hepatic glucose production in diabetes, because insulin resistant, so insulin doesn't inhibit this increased lipolysis (MOA of DKA, but DKA usually only occurs in T1DM) pancreatic islets Pathophysiology in T2DM Also lower insulin production in insulin in response to a meal by beta cells, pancreas also less of an incretin effect** Think of the Pancreatic eta-cell as a worker whose job it is to make insulin. At baseline, the worker has inherited genes that limit his or her ability to make an adequate amount of insulin when the demand for insulin is increased (eta-cell dysfunction) In the setting of insulin resistance, the worker is being asked to work harder and harder. (16 hour day instead of an 8 hour day) Over time, the worker is unable to compensate for the increased work demand and the productivity (insulin production) decreases as the worker gets "burned out." Lifestyle modifications and a low carbohydrate diet can decrease the work demand on the worker. Dirunal secretion in T2DM of insulin is lost/dimished? Insulin Resistance in Type 2 Diabetes Mellitus: Beyond Obesity Continue reading >>

Diabetes Flashcards | Quizlet

Diabetes Flashcards | Quizlet

Factors that produce falsely high HbA1c levels If there is a decrease in RBC turnover rate due to untreated vitamin deficiency anemia's Factors that produce falsely low HbA1c levels Increase in RBC turnover rate due to RBC breakage or blood loss, recent transfusions, Rx vitamin deficiencies and hemoglobin disorders When will Glycosylated serum protein/albumin test be performed This test will occur when blood glucose control needs to be identified in a shorter period (2-4 wks) and tight control is needed; good range to be in is 11-16% Performed during acute illness/stress/pregnancy/BG levels >300/s&sx of DKA (fruity breath,ortho hyp, tachycardic, poor turgor, decreased neck vein filling, hypercapnia, n/v); Indicates there is a severe lack of insulin and body has broken down too much fat and can lead to DKA, metabolic acidosis IV fluids and insulin, monitor patient frequently but dont worry if ketones are not absent from urine right after When 30-300mg of albumin are found in urine within 24 hours (microalbuminuria); when creatinine levels are elevated due to hypertension and poor glucose control Diagnostic oral glucose tolerance test values (2hr reading) Polyuria, Polydipsia, Polyphagia, Weight loss, fatigue, increase frequency of infections, rapid onset of disease, insulin dependent, familial tendency, peak incidence 10-15 yo Sedentary lifestyle, Familial tendency, Average dx is at age 50, hx of hypertension, fatigue, decreased energy level, obese, recurrent infections, polyuria, polydipsia, polyphagia, FBS >126 hot, dry, can be moist, dehydrated, rapid kussmauls, can be alert but can be suporous, acetone breath, nausea/vomiting, decreased neck vein filling, tachycardia, orthostatic hypertension; dx >250 cold, clammy, weak, double vision, tachycardia, headache, palpita Continue reading >>

Diabetes Flashcards | Quizlet

Diabetes Flashcards | Quizlet

The usual treatment for diabetes is diet, rest, and insulin. A person with diabetes who overdoses on insulin may develop a very high blood sugar. A person with diabetes may develop ulcers and gangrene of the lower extremities as a result of vascular disease. One test that may be used to diagnose diabetes is the oral glucose tolerance test Insulin may be administered orally or sub q Diabetes that requires daily insulin injections Diabetes that is often associated with obesity Diabetes that is caused by certain medications or illness The presence of impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) A normal fasting glucose in a person that does not have diabetes is? What should pre-meal blood glucose be in a person with diabetes? HbA1c of what percent or greater is diagnostic for diabetes mellitus? A fasting blood glucose of ___ or greater is diagnostic for diabetes for mellitus? An acutely ill patient in the hospital should maintain blood glucose between 140 and ? Hypoglycemia is defined as a glucose level of less than? Continue reading >>

Diabetes Testing (211 Endocrinology)

Diabetes Testing (211 Endocrinology)

Other sites (forearm/thigh) used, but have 20 minute lag time as compared to finger Helps guide self management of exercise, diet & meds Improves blood glucose control through immediate patient feedback In normal people, 3-6% of hemoglobin is glycosylated in the form A1c Provides information that spot blood checks might miss Gives info about long term glycemic control Normalizes w/in 3 weeks of normoglycemic levels Older RBCs have higher HbA1c levels; patients with episodic or chronic hemolysis who have larger proportion of young RBCs might have spuriously low levels Goal < 7% HbA1c (adjust therapy if > 7%) Lowering by any amount will improve health outcomes Essential for patients who do not check own blood sugar If good DM control, check HbA1c 1 -2 times yearly If suboptimal DM control, check HbA1c every 3 months Point-of-care HbA1c assays are NOT sufficiently accurate to use for diagnostic purposes A1c determinations CANNOT be used for diagnosis or monitoring in patients with conditions that affect formation and/or turnover of RBCs (some hemoglobinopathies or ANEMIAS from hemolysis & iron deficiency) = glycated albumin or glycated serum protein Reflects hyperglycemic period w/in last few weeks Gives info of relatively short term glycemic control Useful for patients with chronic hemolytic anemias that cause shortened RBC life span Normal values vary in relation to serum albumin (1.5-2.4 mmol/L when serum albumin is 5 g/L) Limited use in patients with low serum albumin (nephrotic state or hepatic disease) Continue reading >>

Treatment And Diagnosis Of Diabetes Mellitus Type 2

Treatment And Diagnosis Of Diabetes Mellitus Type 2

6.5%+ is indicative of diabetes if confirmed by repeat testing What is fasting and post-prandial plasma glucose and what are normal levels in healthy non-diabetics individuals? Fasting Plasma Glucose (FPG)- blood glucose is measured after an overnight fast (8-10 hours) o FPG in a non-diabetic should be <100 mg/dL Post-prandial (random) plasma glucose (PPG)- non-fasting blood glucose measurement o PPG in non-diabetic should be <140 mg/dL What is pre-diabetes and how is it diagnosed? Pre-Diabetes refers to impaired glucose tolerance and impaired fasting glucose; it is associated with physical inactivity, obesity, dyslipidemia, and hypertension These are not clinical entities, but rather risk factors for developing diabetes and CVD 2 hr Oral Glucose Tolerance Test (OGTT) 140-199 mg/dL following a 75g glucose load Fasting plasma glucose 100-125 mg/dL (after 8 hour fast) How can type 2 diabetes be prevented or delayed? Refer pre-diabetic individuals to ongoing support programs: target weight loss of ~7% Body weight, increased exercise. Follow Up counseling and monitoring of pre-diabetic individuals Metformin drug to prevent T2DM in pre-diabetic individuals Screen and treat modifiable risk factors for CVD Diabetes self-management education programs What is the criterion for diagnosis for type 1 and type 2 diabetes? Following 4 categories for diagnosis of both type 1 & 2 diabetes A1C 6.5 (test should be performed in a lab using a method that is NGSP certified and standardized to the DCCT assay) or 2 hr OGTT 200 mg/dL (following 75 g glucose load) or FPG 126 mg/dL (after an 8 hr fast) or Symptoms of DM and a random blood glucose 200 mg/dL When should testing for diabetes in asymptomatic patients begin? In adults with BMI 25 or Asian American adults with BMI 23 with one or more Continue reading >>

Medical Assisting-kinns-diabetes

Medical Assisting-kinns-diabetes

Which type is responsible for 90-95% of cases? How many are estimated to be prediabetic? Diabetes is in people of all ages and races---who are most common? African American, Latino, Native American, and Asian Americans/ Pacific Islanders What produces and secretes the hormones insulin and glucagon? Pancreas-contains islets of Langerhans which produce and secrete the hormones When blood glucose level is too high, what happens? beta islet cell secrete insulin which is sent through the bloodstream to target tissue site to conduct glucose into the cell What happen when blood glucose level is to low? alpha islet cells secrete glucagon to stimulate the liver to convert glycogen into circulating glucose Diabetes diagnosis, Plasma glucose level of >_______ classic symptoms of polyuria, polydipsia, and unexplained wt loss Diabetes diagnosis, fasting plasma glucose level of >_______ > 126 mg (norm 70-110) on more than one occasion Diabetes diagnosis, two hour oral glucose tolerance test result > Diabetes diagnosis, positive urinalysis for__________ Diabetes diagnosis, hemoglobin level of > Prediabetes diagnosis, glucose level is _________, but not enough to classify as Type 2. Prediabetes can cause long-term damage to_____________. Prediabetes patients, do they develop Type 2 diabetes? studies indicate that the majority of people with prediabetes develop type 2 within 10 years. Prediabetes, what type of weight lose is recommended? If 200 or higher is a diagnosis of diabetes Fasting blood sugar (FBS)taken after patient has been without food or drink for 12 hours; more accurately assesses blood glucose level than random level. Glucose tolerance test (GTT) measures body's ability to metabolize concentrated oral glucose load; first draw a FBS, then measure glucose levels from 1 to 5 Continue reading >>

Diagnostic Testing In Diabetes (cs)

Diagnostic Testing In Diabetes (cs)

IFG = 100-125 after 8hr fast, considered prediabetic self blood glucose monitoring or "point of care" BG monitoring uses glucometer, test strips, alcohol wipes, lancet, bandaid for pts who need more than 3 doses of insulin per day, or who have recurrent episodes of extreme hypoglycemia patch and catheter inserted into SubQ tissue measures and records glucose in IF over 3-4 days assesses insulin response to glucose load used in prediabetics, pregnancy, w/u of hypoglycemia must fast for 12hrs prior, no low carb diets, test in AM used for GDM screening at 24-28 weeks gestation Given over 5 minutes after 1st fasting specimen drawn direct measurement via fasting venous specimen reassess s/p arginine infusion (should increase) used to w/u pt w glucagonoma, hypoglycemia <300mg not detected on traditional dipstick ADA: screen T1 5yrs after dx, then yearly; T2 ASAP, yearly screen via DFE w monofilament (skin, pulses, sensory) body is trying to get blood, oxygen, sugar to tissues Continue reading >>

Hba1c And Self Monitoring

Hba1c And Self Monitoring

target should be agreed between pt and dr depending on patients comorbidities, life expectancy, hypoglycaemia, frequency don't test more frequently than every three months Patients suspected of having type 1 diabetes. Patients with symptoms of diabetes for less than two months. Patients at high diabetes risk who are acutely ill. Patients taking medication that may cause rapid glucose rise - eg, steroids, antipsychotics. Patients with acute pancreatic damage, including pancreatic surgery. Presence of other factors that influence HbA1c and its measurement: Increased HbA1c: iron deficiency, vitamin B12 deficiency, decreased erythropoiesis. Decreased HbA1c: administration of erythropoietin, iron, vitamin B12, reticulocytosis, chronic liver disease. Genetic or chemical alterations in haemoglobin: haemoglobinopathies, HbF and methaemoglobin may increase or decrease HbA1c. Increased HbA1c: alcoholism, chronic kidney disease. Decreased HbA1c: aspirin, vitamin C and vitamin E, certain haemoglobinopathies. Increased HbA1c: increased erythrocyte lifespan - eg, splenectomy. Decreased HbA1c: decreased erythrocyte lifespan - eg, haemoglobinopathies, splenomegaly, rheumatoid arthritis or drugs such as antiretrovirals, ribavirin and dapsone. Increased HbA1c: hyperbilirubinaemia, alcoholism, large doses of aspirin, chronic opiate use. glycated fraction of all plasma proteins (predominantly albumin) reflects average glucose in last two weeks not available everywhere but may be useful in reduced red cell survival time HbA1c, blood glucose, urine glucose (only for diet or tablet controlled T2DM as a warning sign of pt becoming unwell) pt needs to be educated on how to respond to hypo or hyper before breakfast, patient empties bladder after waking and then, after 30 minutes passes another Continue reading >>

Week 2 Flashcards | Quizlet

Week 2 Flashcards | Quizlet

What is the normal range for fasting glucose? What fasting glucose level is diagnostic for diabetes? What is the normal range for the 2 hour glucose tolerance test? What 2 hour glucose tolerance range is diagnostic for diabetes? What does the presence of microalbumin in urine indicate? Can microalbumin be measured on a urine dipstick? Not specifically, but protein will be positive. Describe how Preproinsulin is cleaved to make insulin. Preproinsulin is cleaved to Proinsulin, which is cleaved to Insulin + C-peptide. In what ratio are C-peptide and Insulin produced? What are the 3 types of urine ketones, in order from largest to smallest concentration? How does HbA1c relate to long term glucose management? HbA1c correlates to the average life span of RBCs (120 days), thus reflecting an average blood glucose for the past 2-3 months. Conditions that shorten RBC life span: Sickle cell disease, hemorrhage, and hemolytic anemia decrease HbA1c values. Iron deficiency anemia increases HbA1c values. What cutoff value of HbA1c is diagnostic for diabetes? What does the Acetest detect? When will it be positive? What is the name of the reagent? Positive due to the presence of serum ketones. What is the normal range for arterial pH? How does the value change in ketoacidosis? What blood samples are used for Glucose measurement? Serum or plasma in a NaF gray top tube to prevent glycolysis. What special preparation should be done before a glucose tolerance test? Patient should ingest a normal carbohydrate load (150g a day) for the 3 days prior to testing. Patient should also fast prior to the blood draw. What is the empirical formula for Glucose? Who is at risk for hyperglycemic non-ketotic hyperosmolar syndrome? Older individuals with Type 2 Diabetes who are living alone or incapacitat Continue reading >>

Large Group- Type 1 Diabetes

Large Group- Type 1 Diabetes

As a patient goes from using glucose to fat for energy what acid accumulates in the body? What happens to creatinine levels in a patient with Type 1 Diabetes? Why? Increase because a lack of insulin means there is a lack of protein uptake by cells An eletrophoretically fast moving hemoglobin component found in normal persons What is the connection between HbA1C and glucose? It increases in the presence of hyperglycemia and may reflect glucose levels in the blood over a period of time In a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose What does the level of HbA1c reflect? Why? The mean blood glucose concentration over the preceding 6-8 weeks due to the fact that an erythrocytes half life is typically 60 days What is the pathophysiology of Type 1 Diabetes? - Lymphocytes begin to infiltrate and destroy insulin secreting beta cells of the islets of Langerhans. As beta cell mass declines insulin secretion decreases until it can no longer maintain normal blood glucose levels What % of beta cells need to be destroyed for hyperglycemia and diabetes to be diagnosed? What is considered the major factor in the pathophysiology of Type 1 Diabetes? What virus has been linked to the onset of Diabetes? A combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells What has insulin resistance been attributed to? Elevated levels of free FA's and pro-inflammatory cytokines in plasma Decrease glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat In a Type 1 Diabetic, will they have decreased, normal, or high levels of insulin? In a Type 2 Diabetes, will they have decreased, normal, or high levels of insulin? The majority of undiagnosed cases of diabetes are of what typ Continue reading >>

Hemoglobin A1c: Glycated Hemoglobin (ghb)

Hemoglobin A1c: Glycated Hemoglobin (ghb)

Sort Overview: --Since RBC's survive an average of 120 days, the measurement of GHb provides an index of a person's average blood glucose concentration (glycemia) during the preceding 2-3 months. --Normally, only 4-6% of Hgb is bound to glucose, while increased glycohemoglobin levels are seen in diabetes and other hypolycemic states. --In an attempt to standardize the clinical measurements, most assays now in use clinically measure A1c, or are calibrated to produce a result equivalent to such a measurement. Use for the diagnosis of DM with A1c > or = 6.5%: --Does not require fasting prior to test. --Does not require multiple blood draws or a prolonged time commitment. --Detects poor glycemic control in pt's who only check fasting or random glucose readings. --Detects more pt's with DM, at an earlier point in the disease. --Should be confirmed with repeat A1c testing. Indicated at the time of initial diagnosis of DM, then: --3-month interval testing in type I DM. --6-month interval testing in type II DM in pt's meeting treatment goals & having stable glycemic control. (Testing may be needed more frequently as required for glycemic control.) --Unstable or highly intensively managed pt's (eg, pregnant type I diabetic women) may be tested more frequently than every 3 months. Contraindications for A1c measurement: --Conditions with abnormal red cell turnover, such as anemias from hemolysis & iron deficiency. --Presence of hemoglobinopathy with normal red cell turnover (eg, sickle cell trait) requires a specialized A1c assay without interference from abnormal hemoglobins. --Pt's with > 10% Hb F will have lower than expected A1c results. Normal Values/findings of A1c: A1c by age: < 6 y: 7.5-8.5% 6-12 y: <8% 13-19 y: < 7.5% >19 y: < 5.7% Causes of misleading decreases in A1c: - Continue reading >>

Diabetes- Ati Testing

Diabetes- Ati Testing

Sort What are the risk factors for DM? Genetics may predispose an individual to the occurrence of type 1 or type 2 diabetes. Toxins and viruses can predispose an individual to diabetes by destroying the beta cells leading to type 1 diabetes mellitus. Obesity, physical inactivity, high triglycerides (greater than 250 mg/dL), and hypertension may lead to the development of insulin resistance and type 2 diabetes. Secondary causes of diabetes include pancreatitis and Cushing's syndrome. What are the nutritional guidelines for patient's with DM to follow when sick? ■■ Monitor blood glucose every 3 to 4 hr. ■■ Continue to take insulin or oral antidiabetic agents. ■■ Consume 4 oz of sugar-free, non-caffeinated liquid every 0.5 hr to prevent dehydration. ■■Test urine for ketones and report to provider if they are abnormal (the level should be negative to small). Call the health care provider if: ■■ Blood glucose is greater than 240 mg/dL. ■■Fever is greater than 38.9° C (102° F), does not respond to acetaminophen, or lasts more than 12 hr. What patient education should be provided for S & S of hypoglycemia? ☐☐ Treat with 15 to 20 g carbohydrates Examples - 4 oz orange juice, 2 oz grape juice, 8 oz milk, glucose tablets per manufacturer's suggestion to equal 15 g ☐☐ Recheck blood glucose in 15 min. ☐☐ If still low (less than 70 mg/dL), give 15 to 20 g more of carbohydrates. ☐☐ Recheck blood glucose in 15 min. ☐☐ If blood glucose is within normal limits, take 7 g protein (if the next meal ismore than an hour away). Example - 1 oz of cheese (1 string cheese), 2 tablespoons of peanutbutter, or 8 oz of milk Oral hypoglycemics ■■ Alpha-Glucosidase Inhibitors - Acarbose (Precose) and miglitol (Glyset) ☐☐ Slows carbohydrate absorpti Continue reading >>

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