Glucose level of 150: Breathe Well-Being – Your Guide to Health, Fitness, Nutrition and Well-being

07.08.202322.06.2023 by alexxlab

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Breathe Well-Being – Your Guide to Health, Fitness, Nutrition and Well-being

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Breathe Well-Being – Your Guide to Health, Fitness, Nutrition and Well-being

Control of diabetes compensation

A glycated hemoglobin (HbA1C) and blood glucose test used to evaluate the effectiveness of diabetes treatment.

Synonyms Russian

Control tests in the treatment of diabetes mellitus, glycated hemoglobin and blood sugar.

Synonyms English

Diabetes Mellitus (DM) glycemic control, DM glycemic goals, HbA1 Cand blood glucose.

What biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

Do not eat for 12 hours before the test, you can drink pure non-carbonated water.
Exclude physical and emotional overexertion within 30 minutes prior to the study.
Do not smoke for 30 minutes before the test.

General information about the study

Treatment of diabetes mellitus (DM) is aimed at eliminating the symptoms of the disease and reducing the risk of micro- and macrovascular complications. Good blood glucose control is a fundamental principle in the treatment of diabetes. The studies revealed the following patterns:

the frequency of microvascular complications is reduced by 25% at the level of Hb1Ac7% compared with the level of 7.9%;
a 1% reduction in Hb1AC is accompanied by a 35% reduction in the risk of microvascular complications;
glucose control does not significantly affect the risk of macrovascular complications (myocardial infarction, stroke, peripheral arterial atherosclerosis).

In clinical practice, the following indicators are measured to evaluate the effectiveness of treatment:

1. Blood glucose

It is desirable that the glucose level during treatment approaches the norm (90-130 mg / dl before meals). However, “strict” glycemic control can lead to episodes of hypoglycemia and is not always justified in elderly patients with heart disease or cerebrovascular disease. In such cases, a glucose level of 100-150 mg/dL may be considered optimal. Most people with diabetes have regular self-monitoring of their blood glucose with a portable glucometer. Measurement of blood glucose levels in the laboratory is at the discretion of the physician.

2. Glycated hemoglobin Hb 1 AC

The American Academy of Clinical Endocrinologists (AACE) 2013 guidelines for Hb1AC to be less than 6.5 % provided that the patient is in otherwise healthy person without high risk of hypoglycemia. In other cases, this figure may be higher, for example:

patients with one or two coexisting chronic diseases and normal cognitive function: target HbA1C less than 7.5%;

90,027 patients with multiple coexisting chronic conditions or mild to moderate cognitive impairment: target HbA1C < 8%;

90,027 patients with multiple advanced chronic diseases or severe cognitive impairment: target HbA1C < 8.5%.

Glycated hemoglobin is recommended to be measured every 3 months when treated with insulin or every 3-6 months when treated with oral hypoglycemic agents.

In the treatment of anemia in chronic kidney disease and DM with iron and erythropoietin preparations, the HbA1 index decreases independently of the blood glucose level and therefore loses its information value. This phenomenon is probably associated with the formation of new red blood cells, which changes the ratio of young (non-glycated) and old (glycated depending on blood sugar) cells. In such a situation, it is better to replace the HbA1C indicator with glycated albumin.

It is important to note that blood glucose is not the only parameter requiring physician attention when treating a patient with diabetes. Diagnosis and treatment of dyslipidemia and assessment of nephropathy are of great importance.

What is research used for?

To evaluate the effectiveness of diabetes treatment.

When is the test ordered?

Every 3-6 months when treating a patient with diabetes.

What do the results mean?

Reference values

For each indicator included in the complex:

[06-014] Glycated hemoglobin (HbA1c)
[06-015] Plasma glucose

Target blood glucose level:

90-130 mg/dl (in older patients with heart disease or cerebrovascular disease, a higher value, such as 100-150 mg/dl, may be considered optimal).

Desired glycated hemoglobin HbA1C:

less than 6.5%%).

What can influence the result?

Patient non-compliance with prescribed treatment;
treatment of anemia in CKD with iron and erythropoietin preparations.

Important remarks

In the treatment of anemia in chronic kidney disease with iron and erythropoietin preparations, the HbA1C indicator is uninformative, it is better to replace it with glycated albumin.

Also recommended

[40-039] Lipidogram

[06-114] Urinary albumin (microalbuminuria)

[41-001] Cardioprognosis

Who prescribes the test?

Endocrinologist, internist, general practitioner.

Literature

Ng JM, Cooke M, Bhandari S, Atkin SL, Kilpatrick ES. The effect of iron and erythropoietin treatment on the A1C of patients with diabetes and chronic kidney disease. Diabetes Care. 2010 Nov;33(11):2310-3.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010 Jan;33 Suppl 1:S62-9.

Glucose tolerance test – Altamed+

Disorders of carbohydrate metabolism have complex consequences, therefore, a glucose tolerance test is recommended in the following cases: heredity; excess weight; the presence of glucose in the urine; if fasting blood glucose levels are higher than normal; if pregnant women in the second trimester have high fasting glucose levels; symptoms of diabetes; poorly healing wounds on the skin.

Contraindications for GTT are: previously diagnosed diabetes; hepatitis; cirrhosis of the liver; recent heart attack; menstruation; exacerbation of diseases, acute infectious and inflammatory processes.

How the laboratory test is performed

Before testing , you must limit physical activity, do not drink alcohol or smoke, do not brush your teeth or chew gum, test only in a healthy state, and exclude medication.

First of all, on an empty stomach, the patient donates blood from a vein, and laboratory assistants determine the level of glucose in it.

Next, you need to drink 75 g of pure glucose dissolved in 300 ml of water.

After two hours, the patient donates blood again, the glucose level is determined, and the doctors monitor the dynamics after the test.

Pre-test

Available only if you have preliminary fasting, no-load glucose results. The content of glucose in the blood plasma is determined on an empty stomach and 2 hours after a glucose load.

It is necessary to follow a normal diet (with a carbohydrate content of more than 125-150 g per day) and adhere to the usual physical activity for three days before the study. The study is carried out in the morning on an empty stomach after an overnight fast for 12-16 hours (at this time you can not smoke or drink alcohol).

During the examination, the patient should lie or sit quietly, do not smoke, do not get cold and do not engage in physical work.

It is not recommended to conduct a study after and during stressful effects, after operations and childbirth, with inflammatory processes, alcoholic cirrhosis of the liver, hepatitis, during menstruation, with gastrointestinal diseases with impaired glucose absorption.

Before the test, it is necessary to exclude medical procedures and medication (adrenaline, glucocorticoids, contraceptives, caffeine, thiazide diuretics, psychotropic drugs and antidepressants).

Cancellation of drugs is made only after prior consultation of the patient with the doctor.

Children under 14 years of age do not have a glucose tolerance test.

Pregnant women are advised to carry out a glucose tolerance test at 24-28 weeks of gestation, which allows them to detect with an accuracy of 98% of women with gestational diabetes.

Test results

When blood is taken from a fasting vein, the sugar level should not exceed 4.0-6.1 mmol/l. After taking a glucose solution in an hour, its level rises to 8. 0 -10.0 mmol / l, and after two hours the indicators should not exceed 7.8 mmol / l.

If, after taking 75 g of glucose, the sugar level is above 7.8, but below 11.1 mmol / l, this indicates a hidden violation of carbohydrate metabolism in the patient’s body, that is, at an early stage, the so-called prediabetes.

In any case, after a glucose tolerance test, it makes sense to show the results to an endocrinologist for a correct interpretation of the results.

Detection of diabetes in pregnant women

In pregnant women, a glucose tolerance test is performed at 24-28 weeks of pregnancy; if symptoms of diabetes are present, GTT is performed before the 24th week.

According to statistics, gestational diabetes (pregnancy diabetes) affects 14% of expectant mothers. This is due to the fact that the body during pregnancy should produce more insulin, if this does not happen, the glucose level rises and gestational diabetes begins to develop, which will require additional medical supervision.

Glucose level of 150: Breathe Well-Being – Your Guide to Health, Fitness, Nutrition and Well-being

Breathe Well-Being – Your Guide to Health, Fitness, Nutrition and Well-being

Breathe Well-Being – Your Guide to Health, Fitness, Nutrition and Well-being

Control of diabetes compensation

Glucose tolerance test – Altamed+

How the laboratory test is performed

Pre-test

Test results

Detection of diabetes in pregnant women

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