Type I is sometimes called ‘juvenile onset’ diabetes, because the condition is most often recognized during childhood. It is a severe condition, resulting from the autoimmune destruction of the insulin-producing beta cells in the pancreas. The treatment is usually a daily injection of a preparation of the hormone insulin to correct the endocrine imbalance, coupled with careful management of the diet. This is to make sure that the insulin which has been injected into the blood stream has the correct amount of calories to deal with – too few and hypoglycaemia (markedly low blood sugar concentration) could occur and too many might allow hyperglycaemia to develop.
In diabetes mellitus, higher amounts of glycated haemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, and retinopathy.
Glycated haemoglobin (HbA1c) is a form of haemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by haemoglobin’s exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated haemoglobin. As the average amount of plasma glucose increases, the fraction of glycated haemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous 2 to 3 months prior to the measurement.
There is no standard reference range available for this test. The reference values depend upon the factors of patient age, gender, sample population, and test method. Hence, each laboratory reports will include the patient’s specific reference range for the test in essay writing services assistance. An increase in fructosamine in lab testing results usually means an increase in glucose in the blood.
Venous plasma glucose
A glucose drink is given containing a standard amount of glucose (75g). Blood samples are taken before the drink is given and two hours later. The test should be done at 9 am after an overnight fasting. A two-hour blood glucose level above 11.1mmol/l is a diagnosis of diabetes. A level below 7.8mmol/l is normal.
Chronic ‘hyperglycaemia’ (excessively high blood sugar concentration) is mainly caused by insulin deficiency, insulin resistance or both, and this is known as Diabetes Mellitus. Diabetes Mellitus may be primary or secondary. Primary diabetes is of 2 types; Type I and Type II.
Fasting plasma glucose
Random blood glucose level: glucose levels are taken at a random time on two occasions. Any figure above 11.1mmol/L is a diagnosis of diabetes. Secondary diabetes mellitus can be caused by diseases of the pancreas, acromegaly, Cushing’s disease or drug administration. If the diagnosis is still unclear from these tests, a glucose tolerance test can be carried out. General targets for HbA1c of 6.5-7.5% should be set for an individual The recommended target of 6.5% and 7.5% are 48 mmol/mol and 59mmol/mol in the new units. Fasting glucose test: the glucose level is measured after an overnight fast and on two different days. A level above 7.0mmol/L is a diagnosis of diabetes.
Although not fatal, uncontrolled diabetes can cause serious long-term complications include cardiovascular disease, chronic renal failure, diabetic retinal damage (retinopathy), degeneration of the nervous supply, particularly to the leg muscles (neuropathy), and problems with the circulation to the extremities causing loss of function and even gangrene in the toes.
It is therefore important to identify people who might have, or be at risk of developing, type II diabetes and this can be achieved by testing their blood sugar levels as part of a general health screen or if they have the classical symptoms of frequent urination (polyuria), increased thirst (polydipsia) and increased hunger (polyphagia). To diagnose Diabetes Mellitus glucose levels are measured in blood samples, which you can get from help in research paper writing service. This is done using the following tests:
Fasting plasma glucose
HbA1c test is not appropriate where there has been a recent change in diet or treatment within 6 weeks, or if there are abnormalities of red blood cell aging or mix of haemoglobin subtypes (predominantly HbA in normal adults). Hence, people with recent blood loss or haemolytic anaemia, or haemoglobinopathy such as sickle-cell disease, are not suitable for some glycosylated haemoglobin methods that do not account for higher-turnover haemoglobin. Fructosamine is used in these circumstances, as it also reflects an average of blood glucose levels, but over a shorter period of 2 to 3 weeks. Fructosamine is also of use in conditions, such as pregnancy, in which hormonal changes cause greater short-term fluctuation in glucose concentrations.
Type II diabetes initially arises from a diminished sensitivity of cells and tissues to insulin and tends to become noticed in middle age. It is usually a less dangerous condition and can be effectively treated with drugs and sometimes simply a stricter control of the diet alone. Because it is uncommon for people with untreated type II diabetes to be acutely ill and go into a coma, many individuals do not notice or actually ignore their symptoms. Although it is not fully clear why some people develop diabetes, both type I and II forms are thought to occur due to complex interaction of genetic susceptibility and environmental factors. Since 1st June 2009 the way HbA1c results are reported in the UK has changed to help standardise measurements.