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Blood Testing for Diabetics

Starting with the understanding that the cells in our body need a constant supply of glucose as a source of energy.

By definition, a diabetic has an impaired ability to maintain a safe level of glucose in the blood.

For the diabetic, testing for sugar (glucose) in the blood is a requirement that must be observed.

Home daily blood testing device

Home daily blood testing device

It is the only way to know whether your blood-glucose is within a safe range, and if not, then a decision can be made on what actions should be taken to bring blood-glucose levels back to acceptable values. This assessment will take more than one blood test but by performing a series of tests over suitable intervals of time, the results should provide the necessary information to determine how the body is managing its glucose load. Testing falls into two categories: Self-tests and Clinical tests.

Self Monitoring Tests

Self testing is a simple procedure and is usually done daily first thing in the morning on an empty stomach, and then, perhaps, with multiple blood tests each day. With the aid of a small blood glucose monitor, a test strip, and a small device enabling the almost painless pricking of the end of a finger, a very small drop of blood can be obtained and applied to the test strip which is then read by the monitor and within a few seconds the numeric result appears on the monitor’s screen. These obtained values and the date and time of their test should be recorded in a suitably simple fashion in order to gain a “picture” of what is occurring over any given time period, perhaps just a few days to weeks, or whatever length of time it takes to show the overall level of control. Without such a regular everyday testing routine it is not possible to know how well the diabetes is being controlled. The glucose levels in the blood vary depending on times and types of meals or food eaten during the preceding period. Instructions and advice on timing of self monitoring of blood tests should be obtained from the doctor.

Target reading on the blood testing monitor

While it is not necessary to know the details of the chemical units used in blood testing, it should be mentioned that the United States uses different measuring units than does the rest of the world. So for a US person the target reading would be between 108 and 124 mg/dl (milligrams per deciliter) whereas persons in Canada, the United Kingdom, Europe and elsewhere in the world would target for between 6.0 and 6.9 mmol/L (millimoles per Liter).

Clinical test:
The A1C or Glycosylated Hemoglobin Test

These are usually done three of four times per year and are performed by a medical laboratory on blood taken at a clinic by a technician. It is from the clinical test that the diabetes sufferer is able to find out their real condition extending back over the previous three or four months. This is based on the fact that the lifetime of red blood cells is approximately 120 days. About two million new red blood cells are being produced by your bone marrow every second and just as many are dying every second, having reached their approximate lifespan of 120 days. So that means there is a mix of cells of every age from seconds to 120 days in your bloodstream and in taking a blood sample, chemical analysis by the laboratory will determine average levels of glucose existing in your body over that previous 120 period.

But more than glucose levels are usually measured in the laboratory analysis. It is customary to also analyze for other relevant biochemical substances, including creatinine, albumin, cholesterol and so on, levels of which are necessary to enable the physician to evaluate the progress and effectiveness of a patient’s regime for controlling their condition.



An Explanation of Diabetes, Glucose, and Insulin

The importance of glucose and Insulin

Diabetes is a disease in which an above normal amount of glucose circulates in a person’s bloodstream causing a dangerous health risk if it cannot be lowered to a safer level.

In non-diabetic people, the body has the ability to regulate the levels of glucose in the blood and to maintain those levels within a safe range but in those with diabetes that regulating system becomes impaired.

Cells

The cells of our body need a constant supply of glucose, it is glucose that is the primary source of energy for those cells. Cells are the basic building blocks of almost all living organisms. Mostly of microscopic size, it is estimated that in the human body there are 60 to 100 billion cells that make up the tissues and organs of an average human adult, together with the cells that exist individually, such as blood cells.
Every cell is a dynamic factory of chemical activities directed towards maintaining the integrity and functioning of the cell and all other cells and tissues and organs. It is the millions of constant chemical transactions that give life to the organism and without glucose, the source of their basic fuel, they could not survive.

Glucose is a simple form of sugar

We get most of our glucose from the carbohydrate portion of our food intake that, in the process of digestion, is broken down into sugar, starch, and fiber. The fiber contributes little or nothing as a source of energy since it is indigestible, although it does have beneficial effects in slowing down the absorption of the glucose into the blood. Like other digested nutrients, the glucose is absorbed through the intestinal walls into the blood stream and transported throughout the body.

The body, in its almost miraculous way, also has a mechanism to provide glucose for the cells, especially after a longer period of time has passed when a person has NOT eaten and when the glucose levels could then have dropped too low. That time period might also include the nighttime when no food has been eaten since perhaps early or mid-evening until the next morning.

When this occurs, the pancreas reacts by sending a hormone, different from insulin, called glucagon and that hormone mediates with the liver to produce glucose. The liver does this by converting glucogen (not to be confused with glucagon, the hormone mentioned above, confusing I know) back to glucose. The glycogen being converted is from original glucose that the liver had absorbed earlier from the bloodstream and which it had stored after altering it to glycogen, recycling is nothing new.

Aided by insulin

In the case of the non-diabetic person, to explain this complex process in simple terms, the glucose is delivered to the cells of the body aided by insulin, a hormone, which is released by an organ called the pancreas into the bloodstream in response to rising glucose levels in the blood occurring as a result of the recent consumption of food. In the bloodstream, the insulin molecules attach to and escort the glucose molecules to the outer membrane of the body’s cells on which there are places known as receptor sites.

The insulin molecules and the cell receptors each have a unique but complimentary matching structural configuration that enables them to join together, a process referred to as “docking”. The insulin then acts like a key to the cell via the receptor, and this allows the attached glucose molecule to be conducted into and absorbed by the cell.

The problem for a diabetic person is that, in their case, the pancreas may not be producing sufficient insulin, or the receptors of the cells may have become less sensitive and not respond correctly to the insulin, with the result that glucose remains in the bloodstream at a harmful level. In some cases both diminished insulin production and the inability of cells to absorb glucose is the case, resulting in above normal levels of both glucose and insulin remaining in the bloodstream, neither of which is a healthy situation.

For this condition, known as diabetes mellitis, also called type 2 diabetes or adult-onset diabetes, the patient’s physician will prescribe appropriate measures to help control the disease. Recommendations may include changes in diet, increasing exercise activities, weightloss, taking prescription medications, perhaps the use of insulin and maybe even, a combination of all of the above.

There is no cure for diabetes at the present time

Once diagnosed as being diabetic the objective is to keep blood glucose levels from rising too high and to prevent the condition from getting worse to an extent where serious complications can occur. Problems can affect several organs, such as the kidneys, the eyes, the nerves, the vascular system – and that can lead to poor circulation sexual dysfunction, and several other unpleasant conditions.

It is well known that this disease in the United States is a leading cause of heart disease and is growing to epidemic proportions with an estimated 24 million cases. The situation is similar in the United Kingdom, Canada and Europe. It appears to be a disease related to modern western lifestyles. Often diabetes goes undiagnosed for considerable lengths of time because many of its early symptoms seem harmless and are ignored. The early symptoms include frequent urination and excessive thirst.

Normal blood glucose levels

Except for a period of up to about two hours shortly after eating, when blood glucose levels immediately rise in response to the recent food intake, the normal range of blood sugar levels for non-diabetic persons is 70 to 108 mg/dl (milligrams per deciliter, in the units of measurement used in the U.S.), or, for outside United States, where different units of measurement are used, the normal levels are between 3.9 and 6.0 mmol/l (millimoles per liter). Unfortunately, the diabetic is unable to achieve and maintain that normal range of blood glucose concentration.

In everyday terms, the normal amount of glucose in the blood of an adult weighing about 165 pounds amounts to only about one and a half ounces. But what trouble and grief is caused by more than that!

Hyperglycemia and Hypoglycemia,
high blood sugar and low blood sugar

The medical term for describing high blood sugars is Hyperglycemia, where levels of glucose in the blood are above 200 mg/dl (11 mmol/l in non U.S. measurements).

But there is another abnormal blood glucose condition, called Hypoglycemia, in which the glucose levels in the blood drop below 60 mg/dl (3.3 mmol/l). That is too low and can be dangerous if it becomes a frequent occurrence and if left untreated it can cause permanent brain damage.

Important roles for patient and doctor

It is necessary for diabetic persons to measure and monitor their blood-glucose levels daily. This can be done at home by the individual with the use of a simple measuring device. People with diabetes must be treated by a qualified physician who will arrange periodic blood tests by a medical clinic about every 3 or 4 months, known as an A1C or HbA test, the results of which will be reviewed by the doctor who can then prescribe an appropriate course of treatment and activity.

For a description of blood testing for diabetics, including self monitoring testing and clinical testing, please click this link: Blood Testing


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