The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal.

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1 Blood Sugars The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. The body naturally tightly regulates blood glucose levels as a part of metabolic homeostasis. Glucose is the primary source of energy for the body's cells, and blood lipids (in the form of fats and oils) are primarily a compact energy store. There are exceptions - for example, because their dietary metabolizable carbohydrates tend to be used by rumen organisms, ruminants tend to be continuously gluconeogenic; consequently their hepatocytes must rely on such primary energy sources as volatile fatty acids, absorbed from the rumen, rather than glucose. Glucose is transported from the intestines or liver to body cells via the bloodstream, and is made available for cell absorption via the hormone insulin, produced by the body primarily in the pancreas. The mean normal blood glucose level in humans is about 4 mm (4 mmol/l or 72 mg/dl, i.e. milligrams/deciliter); however, this level fluctuates throughout the day. Glucose levels are usually lowest in the morning, before the first meal of the day (termed "the fasting level"), and rise after meals for an hour or two by a few millimolar. Normal Human Glucose Blood Test results should be (mg/dl) before meals, and less than 180 mg/dl after meals (as measured by a blood glucose monitor)

2 Diabetes Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). There are three main types of diabetes mellitus (DM). Type 1 DM results from the body's failure to produce insulin, and presently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as "insulin- dependent diabetes mellitus" (IDDM) or "juvenile diabetes". Type 2 DM results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non insulin- dependent diabetes mellitus (NIDDM) or "adult- onset diabetes". The third main form, gestational diabetes occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM. Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis- related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes. Untreated, diabetes can cause many complications. Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma. Serious long- term complications include cardiovascular disease, chronic renal failure, and diabetic retinopathy (retinal damage). Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cessation and maintaining a healthy body weight. All forms of diabetes have been treatable since insulin became available in 1921, and type 2 diabetes may be controlled with medications. Insulin and some oral medications can cause hypoglycemia (low blood sugars), which can be dangerous if severe. Both types 1 and 2 are chronic conditions that cannot be cured. Pancreas transplants have been tried with limited success in type 1 DM; gastric bypass surgery has been successful in many with morbid obesity and type 2 DM. Gestational diabetes usually resolves after delivery. The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in theblood of a human or animal. The body naturally tightlyregulates blood glucose levels as a part of metabolichomeostasis. Glucose is the primary source of energy for the body's cells, and blood lipids (in the form of fats and oils) are primarily a compact energy store. (There are exceptions. For example, because their dietary metabolizable carbohydrates tend to be used by rumen organisms, ruminants tend to be continuously gluconeogenic; consequently their hepatocytes must rely on such primary energy sources as volatile fatty acids, absorbed from the rumen, rather than glucose.) Glucose is transported from the intestines or liver to body cells via the bloodstream, and is made available for cell absorption via the hormone insulin, produced by the body primarily in the pancreas. The mean normal blood glucose level in humans is about 5.5 mm (5.5 mmol/l or 100 mg/dl, i.e. milligrams/deciliter); however, this level fluctuates throughout the day. Glucose levels are usually lowest in the morning, before the first meal of the day (termed "the fasting level"), and rise after meals for an hour or two by a few millimolar. The normal blood glucose level (tested while fasting) for non- diabetics, should be between 70 and 100 milligrams per deciliter (mg/dl). Blood sugar levels for those without diabetes and who are not

3 fasting should be below 125 mg/dl. [5] The blood glucose target range for diabetics, according to the Diabetes Association, should be (mg/dl) before meals, and less than 180 mg/dl after meals (as measured by a blood glucose monitor). Blood sugar levels outside the normal range may be an indicator of a medical condition. A persistently high level is referred to ashyperglycemia; low levels are referred to as hypoglycemia. Diabetes mellitus is characterized by persistent hyperglycemia from any of several causes, and is the most prominent disease related to failure of blood sugar regulation. A temporarily elevated blood sugar level may also result from severe stress, such as trauma, stroke, myocardial infarction, surgery, or illness. Intake of alcohol causes an initial surge in blood sugar, and later tends to cause levels to fall. Also, certain drugs can increase or decrease glucose levels A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage youreyes, kidneys, nerves, and blood vessels. There are several different types of blood glucose tests. Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for prediabetes anddiabetes. 2- hour postprandial blood sugar measures blood glucose exactly 2 hours after you start eating a meal. This is not a test used to diagnose diabetes. Random blood sugar (RBS) measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test. Random testing is not used to diagnose diabetes. Oral glucose tolerance test is used to diagnose prediabetes and diabetes. An oral glucose tolerance test is a series of blood glucose measurements taken after you drink a sweet liquid that contains glucose. This test is commonly used to diagnose diabetes that occurs during pregnancy (gestational diabetes). This test is not commonly used to diagnose diabetes in a person who is not pregnant. Glycohemoglobin A1c measures how much sugar (glucose) is stuck to red blood cells. This test can be used to diagnose diabetes. It also shows how well your diabetes has been controlled in the last 2 to 3 months and whether your diabetes medicine needs to be changed. The result of your A1c test can be used to estimate your average blood sugar level. This is called your estimated average glucose, or eag. To make a diagnosis of type 2 diabetes, your doctor will use the Diabetes Association's criteria. Why It Is Done Blood glucose tests are done to: Check for diabetes. Monitor treatment of diabetes. Check for diabetes that occurs during pregnancy (gestational diabetes). Determine if an abnormally low blood sugar level (hypoglycemia) is present. A test to measure blood levels of insulin and a protein called C- peptide may be done along with a blood glucose test to determine the cause of hypoglycemia. For more information, see the topic C- Peptide. Fasting blood glucose tests are done to detect the risk of diabetes (prediabetes) when glucose levels are mg/dl ( mmol/l), as recommended by the Diabetes Association

4 Diabetic emergencies occur in two forms, Hypoglycaemia and Hyperglycaemia. Hypoglycaemia Hypoglycaemia (also called a hypo, low blood glucose or insulin reaction), is when your blood glucose level has dropped too low. While hypoglycaemia can be experienced by people taking certain tablets for their diabetes, it is more common in people who inject insulin. It is generally not a problem for people with type 2 diabetes who can manage their diabetes through a healthy eating plan and physical activity alone, however, it is possible. It is important to treat a hypo immediately to stop blood glucose level from dropping lower. Symptoms of hypoglycaemia vary from person to person. Signs and Symptoms of Hypoglycaemia are: Weakness, trembling or shaking Sweating Light headedness Headache Dizziness Lack of concentration/behaviour change. Tearful/crying Irritability Hunger Numbness around the lips and fingers.

5 If hypoglycaemia is not treated quickly symptoms may progress to: Loss of coordination Slurred speech Confusion Loss of consciousness Fitting Unconscious, drowsy or unable to swallow Treating Hypoglycaemia: DRSABCD If conscious have some quick acting carbohydrate that is easy to consume. For example: sugar or honey under the tongue if the casualty can tolerate food or drink then.. 1/2 can of regular soft drink (not diet ) OR 1/2 glass of fruit juice OR Glucose tablets equivalent to 15 grams carbohydrate. Wait minutes. If it isn't rising, eat another quick acting carbohydrate from the above list. If your next meal is more than 20 minutes away, eat some longer acting carbohydrate. This could be one of the following: A sandwich OR 1 glass of milk or soy milk OR 1 piece of fruit OR 2-3 pieces of dried apricots, figs or other dried fruit OR 1 tub of natural low fat yoghurt OR 6 small dry biscuits and cheese. If unconscious Call 000 or 112 on a mobile phone for an ambulance Place casualty in recovery position Do not give them any food or drink by mouth Hyperglycaemia Hyperglycaemia means high blood sugar level. This can develop over many hours or days. It is possible for your blood sugar level to be high and you may not even be aware of it. Many people do not experience the symptoms of hyperglycaemia until their blood sugar levels are extremely high. Although their blood contains too much sugar, they cannot tell unless they do a Blood Glucose Level test (BGL) or sometimes Blood Sugar Level test (BSL). Signs and Symptoms of Hyperglycaemia: Feeling excessively thirsty Frequently passing large volumes of urine Feeling tired Blurred vision Infections (e.g. thrush, cystitis, wound infections)

6 Weight loss Treatment of Hyperglycaemia: Seek medical assistance if required If unsure, treat as per hypoglycaemic until you can reach medical aid Videos XJo- k&list=pl749c30f68c00a2fe

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