1 / 52

INTERPRETATION OF BLOOD SUGAR VALUES

INTERPRETATION OF BLOOD SUGAR VALUES. DR.V.SEKAR COIMBATORE DIABETES FOUNDATION. HYPERGLYCEMIA IS THE HALLMARK OF DIABETES. HYPERGLYCEMIA IS THE HALLMARK OF DIABETES. HYPERGLYCEMIA IS THE HALLMARK OF DIABETES. DIABETES TREATMENT IS BASED ON THE NUMBER IN MILLIGRAMS

armand-gutierrez
Download Presentation

INTERPRETATION OF BLOOD SUGAR VALUES

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. INTERPRETATION OF BLOOD SUGAR VALUES DR.V.SEKAR COIMBATORE DIABETES FOUNDATION

  2. HYPERGLYCEMIA IS THE HALLMARKOF DIABETES HYPERGLYCEMIA IS THE HALLMARK OF DIABETES

  3. HYPERGLYCEMIA IS THE HALLMARKOF DIABETES DIABETES TREATMENT IS BASED ON THE NUMBER IN MILLIGRAMS BEFORE WE DECIDE WHETHER BLOOD SUGAR IS NORMAL , HIGH OR LOW

  4. HYPERGLYCEMIA IS THE HALLMARKOF DIABETES HOW THE BOOLD SUGAR IS DERIVED FROM WHERE,WHAT METHOD IS CRITICAL

  5. HYPERGLYCEMIA IS THE HALLMARKOF DIABETES THE MOST CRITICAL ISSUE IS CLINICAL CORELATION BLOOD SUGAR SHOULD NOT BE TREATED THE PERSON WITH BLOOD SUGAR SHOULD BE TREATED

  6. SOURCE OF BLOOD CAPILLARY OR VENOUS PLASMA WHAT METHOD? WHICH MACHINE? MANUAL,SEMI AUTOMATED, FULLY AUTOMATED

  7. STEPS FOR INTERPRETATING BLOOD SUGAR VALUE • PRE ANALYSIS • ANALYSIS • POST ANALYSIS

  8. PRE ANALYSIS • BLOOD COLLECTION • LABELLING • ANTI COAGULANT • CENTRIFUGE

  9. BLOOD COLLECTION

  10. ANTI COAGULANT

  11. LABELLING

  12. CENTRIFUGATION VIDEO

  13. PLASMA

  14. PIPETING 1 ML OF REAGENT 10 MICRO LITER OF PLASMA

  15. TYPES OF MACHINE • TOTALLY MANUAL • SEMI AUTOMATED • FULLY AUTOMATED

  16. ANALYSIS

  17. TYPES OF TESTING GLUCOSE OXIDATES DEHYDROGENASE METHOD (GOD) HEXOKINASE METHOD

  18. TYPE OF REAGENTS END POINT METHOD KINETIC METHOD

  19. TESTING VIDEO

  20. TIME OF TESTING BLOOD COLLECTION TIME TESTING TIME REPORT RELEASING TIME IS MORE IMPORTANT

  21. EVERY ONE HOUR THERE IS A FALL OF 10 – 15 MILLIGRAMS

  22. SAMPLE STORAGE ONLY FOR 24 HRS AT 2 – 8 DEGREE

  23. POST ANALYSIS

  24. REPORT RELEASING VERIFICATION RECHECKING CLINICAL CORRELATION

  25. CALIBERATIONQUALITY CONTROL

  26. WHY FASTING IS HIGH ? • Basal Insulin Deficiency: • Pre Dinner / Post Dinner Blood Sugar Abnormality: • CHO Load:  High Low Medium • Glycaemic Index:  High Low • Fibre Content of Food:  High Low Medium • Time of Food: Untimely Food Timely Food • Somyogi: • Dawn Phenomenon: • Medication: • Check Insulin Vial Clear Turbid Expiry Checked • Storage Area Refrigerator Room Temp • Check Syringe U 40 U100 • Check OHA Less dose Correct dose  High dose • Time of Insulin Correct Time Untime • Insulin Meal Mismatch:

  27. WHY POST PRANDIAL IS HIGH ? • Basal Insulin Deficiency: • Pre Dinner / Post Dinner Blood Sugar Abnormality: • CHO Load:  High Low Medium • Glycaemic Index:  High Low • Fibre Content of Food:  High Low Medium • Time of Food: Untimely Food Timely Food • Somyogi: • Dawn Phenomenon: • Medication: • Check Insulin Vial Clear Turbid Expiry Checked Storage Area Refrigerator Room Temp • Check Syringe U 40 U100 • Check OHA Less dose Correct dose •  High dose • Time of Insulin Correct Time Untime • Insulin Meal Mismatch:

  28. PERSISTANTLY A1C • Diet factor: • High CHO Load Glycaemic index  High, Low Fibre content of the food  High, Low, Medium Time of Food Timely food, Untimely food 2. Exercise : Frequency Intensity Time Type • Aerobics gym yoga exercise

  29. CONT’ 6. Co morbid conditions: HT MAU LIPIDS BDR 7. Complication: IHD PDR NEPHROPATHY NEUROPATHY DFS PVD 8.Doctor factor: Clinical Inertia Selection of drug Dosage

  30. HBA1C MAJESTIC IN THE MANAGEMENT OF DIABETES HBA1C MAJESTIC IN THE MANAGEMENT OF DIABETES

  31. DIABETES MEANS CHRONIC HYPERGLYCEMIA WHAT WE TREAT IS ONLY ACUTE HYPERGLYCEMIA DIABETES MEANS CHRONIC HYPERGLYCEMIA WHAT WE TREAT IS ONLY ACUTE HYPERGLYCEMIA?

  32. BLOOD SUGAR TELLS YOU THE DAY TO DAY VARIATION HBA1C IDENTIFIES THE OVER ALL FLUCCUATION OF BLOOD SUGAR BLOOD SUGAR TELLS YOU THE DAY TO DAY VARIATION HBA1C IDENTIFIES THE OVER ALL FLUCCATION OF BLOOD SUGAR

  33. CLINICAL CASE STUDY MR.SANKARANARAYANAN 60YRS C/O SWELLING IN LEGS HIS HBA1C IS 11.0% CREA 2.4 WITH BDR ON THE DAY OF TESTING

  34. CLINICAL CASE STUDY MRS.PADMINI 60 YRS ON THE DAY OF TESTING HAD BREAKFAST IN HOTEL HER FASTING WAS 140 POST PRANDIAL 260 & HBA1C 6.0%

  35. HBA1C HELPS TO DECIDE ABOUT DIABETES IS UNDER CONTROL OR NOT PREDICTS FUTURE COMPLICATIONS HELPS TO DECIDE THE DIABETES MANAGEMENT

  36. BLOOD SUGAR IS DYNAMIC KEEPS CHANGING WITH EACH MEAL BLOOD SUGAR GOES UP 3 TIMES A DAY 90 TIMES IN A MONTH WE CHECK BLOOD SUGAR ONCE IN A MONTH / FEW MONTHS & DIABETES IS TREATED ON PARTICULAR VALUE UNSCIENTIFIC NOT LOGIC

  37. ROLE OF HBA1C • CONTROL < 7 % • NOT UNDER CONTROL > 7 % • PREDICTS FUTURE • COMPLICATION

  38. DCCT , UKPDS STUDY DECIDE ABOUT THE DIABETES MANAGEMENT

  39. LEVEL OF DECREASE IN HBA1C

  40. CLINICAL DECESION MAKING

  41. 1.SYMPTOMS 2.COMPLICATIONS 3.DURATION OF DIABETES 4.AGE 5.HBA1C 6.TYPE 1 OR TYPE 2 7.INSULIN DEFECIENCY OR INSULIN RESISTANCE 8.WHICH BLOOD SUGAR IS HIGH FASTING OR POST PRANDIAL 9.DIFFERENCE BETWEEN FASTING AND PP 10.DIABETES + OBESITY 11.DIABETES + HYPERTENSION 12.DIABETES + DYSLIPIDEMIA 13.PSYCO – SOCIO STATUS ,ECONOMIC STATUS 14.CO-OPERATION OF THE PERSON AND HIS FAMILY

  42. SYMPTOMS CLINICAL SYMPTOMS ARE THE MOST IMPORTANT PARAMETER IN DECIDING THE TREATMENT PATHWAY Eg: POLYURIA,POLYPHYGIA,POLYDYPSIA,WT LOSS INDICATES A DECOMPENSATED SYMPTOMATIC DIABETES STATUS – NEEDS INSULIN THERAPY SEVERE NEUROPATHY – THE CHOICE IS INSULIN

  43. COMPLICATIONS BASED ON THE MICRO OR MACRO VASCULAR COMPLICATION THE TREATMENT DECESION MAY DIFFER

  44. DURATION OF DIABETES AT DIAGNOSIS 50 % OF BETA CELL IS LOST LONGER THE DURATION MORE LIKELY REQUIRE INSULIN THERAPY

  45. AGE • YOUNG AGE ONSET • MIDDLE AGE ONSET / CLASSICAL ONSET • OLD AGE ONSET YOUNG AGE ONSET MAY REQUIRE A TIGHT CONTROL

  46. HBA1C INDICATES A CHRONIC HYPERGLYCEMIA HBA1C > 10% MAY REQUIRE INSULIN THERAPY

  47. INSULIN RESISTANCE OR INSULIN DEFECIENCY WHICH IS PREDOMINANT ?

  48. FASTING OR POST PRANDIAL WHICH BLOOD SUGAR IS HIGH? WHAT IS THE DIFFERENCE BETWEEN FASTING AND POST PRANDIAL? Eg: BASAL INSULIN TO CONTROL THE FASTING BOLUS TO CONTROL THE POST PRANDIAL

More Related