Test for Carbohydrate

1. According to Bayer, R. (2015

Blood sugar testing or self-monitoring blood glucose provides useful
information for diabetes management. It can help you:

Judge how well you're reaching overall treatment goals

Understand how diet and exercise affect blood sugar levels

Understand how other factors, such as illness or stress, affect blood sugar
levels

Monitor the effect of diabetes medications on blood sugar levels

Identify blood sugar levels that are high or low

Testing with a blood glucose meter is the best way to see the immediate effects of
factors like food choices on your blood sugar, so you can take action to bring high
or low blood sugar back into range. Your health care professional also relies on
your meter results to assess your need for treatment adjustments.
One of the main aims of diabetes treatment is to keep blood glucose levels within a
specified target range. The key is balancing your food with your activity, lifestyle
and diabetes medicines. Blood glucose monitoring can help you understand the
link between blood glucose, food, exercise and insulin.
Over time your readings will provide you and your health professionals with the
information required to determine the best management strategy for your diabetes.
Maintaining good blood glucose control is your best defence to reduce the chances
of developing complications from diabetes.
http://diabetes.ascensia.cz/static/documents/Bayer_reprint_proof1.pdf
2. According to Mandal, A (2015)
3. Glucose can be measured in whole blood or serum (ie, plasma). Earlier
blood glucose was measured in whole blood. Nowadays serum is extracted

from blood and glucose is measured in the serum. Whole blood and serum
blood glucose is often different. Red blood cells have higher concentration
of protein than serum and serum has higher water content and more
dissolved glucose than whole blood. To obtain blood glucose in serum from
figures in whole blood, it is multiplied by 1.15.
4. Blood is collected from a vein (usually in the crook of the arm). The blood
sample is collected into vacuum tubes. Blood sample needs to be collected
from a different arm other than the one where there is the intravenous line to
prevent confusion of the results with the intravenous fluids. After meals the
levels in the veins are somewhat lower than capillary or arterial blood. The
estimate is by about 10%.
5. The surrounding temperature before processing affects blood glucose level
estimation. At refrigerator temperatures, glucose remains relatively stable for
several hours in a blood sample. At room temperature (25 C), a loss of 1 to
2% of total glucose per hour is seen in whole blood samples.
6. If the blood is allowed to clot the glucose in the sample gets metabolized by
the blood cells unless the cells are separated. If there are higher numbers of
red or white blood cells there is excessive glycolysis in the sample with
substantial reduction of glucose level. This occurs if the sample is not
processed immediately and leads to a faulty result.
7. To prevent such losses blood samples are collected in Fluoride tubes (ie,
gray-top) since fluoride inhibits glycolysis. Red-top serum separator tubes
can also be used for samples after being centrifuged isolating the serum from
cells.
8. Timing of the test
9. Blood sugar is measured at various points of time to give an idea about the
bodys blood glucose regulation system. The primary test is the fasting blood
glucose. (FBG). This is measured after overnight fasting. Blood glucose
normally is lowest early in the morning after 6 to 8 hours of fasting
overnight.
10.Two hours post prandial blood glucose or PPG is the next common test.
After a carbohydrate rich, full meal, two hours are allowed to elapse before
blood is taken again for estimation of glucose. This test gives an estimation
of glucose handling by the body.
11.Other tests include oral glucose tolerance test (OGTT) and intravenous
glucose tolerance test (IVGTT) wherein a fixed amount of glucose is
administered orally or intravenously respectively and repeated blood sugar
tests are performed to check on the bodys glucose handling.

12.Another important test is the glycosylated haemoglobin (HbA1C). This test

gives an idea about fluctuations of glucose in blood over a period of last
three months.
13.Blood glucose can also be self-monitored by the patient using meters or
hand help portable monitors. Blood glucose is co-ordinated with urine
glucose test as well.
3. According to Moss, K (2013) http://patient.info/health/pre-diabetesimpaired-glucose-tolerance
Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body
needs glucose to properly function. Your cells rely on glucose for energy.
Hyperglycemia is a defining characteristic of diabeteswhen the blood glucose
level is too high because the body isn't properly using or doesn't make the hormone
insulin.
Ketoacidosis: When Hyperglycemia Becomes Severe for People with Type 1
Diabetes
If you have type 1 diabetes, it is important to recognize and treat hyperglycemia
because if left untreated it can lead to ketoacidosis. This happens because without
glucose, the body's cells must use ketones (toxic acids) as a source of energy.
Ketoacidosis develops when ketones build up in the blood. It can become serious
and lead to diabetic coma or even death. According to the American Diabetes
Association, ketoacidosis affects people with type 1 diabetes, but it rarely affects
people with type 2 diabetes.
Severe hypoglycemia
The symptoms of severe low blood sugar develop when blood sugar falls below
35-40 mg/dL and may include:
* Seizures or convulsions.
* Loss of consciousness, coma.
* Low body temperature (hypothermia).
Prolonged severe hypoglycemia can cause irreversible brain damage and heart
problems, especially in people who already have coronary artery disease. If
emergency medical treatment is not provided, severe hypoglycemia can be fatal.

Some medicines may mask symptoms of low blood sugar, including beta-blockers,
which are often used to treat heart conditions and high blood pressure.
Different people may develop symptoms of mild, moderate, or severe
hypoglycemia at varying blood sugar levels. Although the blood sugar levels listed
above are typical, they may not apply to everyone. If your blood sugar drops
suddenly, you may develop symptoms even if your level is in the normal range.
A number of medical conditions can cause symptoms similar to those of
hypoglycemia. Your doctor will use blood tests and other measures to make sure
another condition isn't causing your symptoms
Cardiovascular disease: affects the heart and blood vessels and may cause fatal
complications such as coronary artery disease (leading to heart attack) and stroke.
Cardiovascular disease is the most common cause of death in people with diabetes.
High blood pressure, high cholesterol, high blood glucose and other risk factors
contribute to increasing the risk of cardiovascular complications.