Glucose tolerance test - Free Essay Example

Sample details Pages: 7 Words: 2010 Downloads: 6 Date added: 2017/06/26 Category Health Essay Type Essay any type Tags: Tolerance Essay Did you like this example? Introduction Carbohydrate forms the principle source of energy. Usually polysaccharide (starch and glycogen) which are glucose units joined by a-glucosidic links and disaccharides (sucrose and lactose) the main dietary carbohydrate. Carbohydrate absorption must be presented to the intestinal epithelium in monosaccharide from mainly glucose and therefore digestion must precede absorption. Don’t waste time! Our writers will create an original "Glucose tolerance test" essay for you Create order Glucose gained a significant importance because brain cells are very dependent on it as it is sole source of energy supply. Red blood cells also depend on glucose to carry out their functions. Therefore the blood glucose concentration must be maintained within relative narrow range. After a carbohydrate-containing meal, glucose is transported in the portal blood to the liver, which takes up 60% of the glucose load. Consequently, a rise in the blood glucose concentration causes the release of insulin which will increase the entry of excess glucose into the liver where it is stored in form of glycogen. The normal plasma glucose concentration remains between 4.5 and 11 mmol/L, despite the intermittent load entering the body from the gastrointestinal tract. The maintenance of plasma glucose concentration below 11 mmol/L minimizes loss from the body as well as providing the optimal supply to the brain. Mayne, (1994). All the filtered glucose through glomeruli is reabsorbed in the pr oximal tubules. Therefore no glucose should be detected in urine; significant glycosuria occurs if the plasma glucose concentration exceeds 11 mmol/L. The two most important hormones in glucose homoeostasis are insulin and glucagon. Insulin is a 53 amino acid polypeptide, secreted by the ?-cells in the islet langerhans of the pancreas in response to a rise in the blood glucose concentration. Insulin stimulates glycogen synthesis and inhibits glycogenolysis through interaction with an exquisitely coordinated control mechanism that is central to the regulation of blood glucose concentration. Glucagon is a 29 amino acid polypeptide secreted by the ?-cells of the pancreatic islet. Its secretion is decreased by a rise in the blood glucose concentration. The action of glucagon is opposite those of insulin. It stimulates hepatic glycogenolysis through activation of glycogen phosphorylase, gluconeogenesis, lipolysis and ketogenesis. Marshell, (2000). The world health organization (WHO ) defined diabetes on the basis of laboratory findings as a fasting venous plasma glucose concentration greater than 7.8 mmol/L and greater than 11.1 mmol/L two hours after the oral ingestion of the equivalent of 75g of glucose even the fasting concentration is normal. Mayne, (1994). Diabetes mellitus classified in two types; insulin dependent diabetes (IDDM type-1) where there is a defective insulin secretion. This condition presents in childhood or early adulthood (less than 20 years). Because of insulin deficiency, hyperglycaemia is very likely to occur. As a result glucose will leak to urine (glycosuria) because the plasma glucose concentration exceeds the renal threshold (10 mmol/l). Other consequences related to this condition are polyuria (frequent urination), glucose lost in urine draw water with it by osmosis producing osmotic diuresis characterized by polyuria. The excess fluid lost from the body leads to dehydration and thirst which is a compensatory mechanism to countera ct the dehydration. One of severe metabolic complication that may occur in this condition is ketoacidosis; there is increased lipid and protein breakdown, enhanced hepatic gluconeogenesis and impaired glucose into cells. Marshall, (2000). In this condition insulin doses are required for the treatment. The causes of the type I diabetes can be an autoimmune where the islet cell antibodies react specifically with the ?-cells, or viral infection that destroy the ?-cells of pancreatic islet. Individual with certain human leukocyte antigen (HLA) types have been shown to carry a particular high risk of developing type I diabetes. In type II diabetes, non insulin dependent diabetes mellitus (NIDDM), obesity is the biggest risk factor, 90% of type II diabetes are obese and it is occurs in the late onset. In this condition ?-cells of islet langerhans are normal which means that there will be a normal insulin concentration and sometimes high in the blood. Also the sensitivity of insulins target cells reduced. The cause of reduced remains elusive, recent research suggest that adipose tissue cells secrete a hormone known as resistin, which interfere with insulin action in experimental animal. This could be an important link between obesity and insulin resistance. Resistin is distinct from leptin, the hormone secreted by adipose cells that plays a role in controlling food intake. (Kumar Clark, 2002). Treatment of this condition by dietary control and weight loss, exercise, sometimes oral hypoglycaemic drugs required. Other conditions can lead to Diabetes Mellitus such as absolute insulin deficiency due to a pancreatic disease (chronic pancreatitis, haemochromatosis, cystic fibrosis). Relative insulin deficiency, can cause diabetes mellitus due to excessive growth hormone, glucocorticoid secretion, or increased plasma glucocorticoid concentration due to administration of steroids. Also drugs like thiazide diuretics can cause diabetes mellitus. Mayne, (1994). Materials and method Please refer to medical biochemistry practical book (BMS2). Result: The equation obtained fro the calibration curve used to calculate the concentration of glucose in plasma. Y = 0.018 X Where y = absorbance x = glucose concentration Patient 1: P (fasting) = 0.078 / 0.018 = 4.3 mmol/L P (2hrs) = 0.105 / 0.018 = 5.8 mmol/L Patient 2: P (fasting) = 0.113 / 0.018 = 6.2 mmol/L P (2hrs) = 0.105 / 0.018 = 8.3 mmol/L Patient 3 P (fasting) = 0.148 / 0.018 = 8.2 mmol/L P (2hrs) = 0.264 / 0.018 = 14.6 mmol/L Conclusion: Patient 1 is normal Patient 2 has normal fasting glucose level and high value after 2 hours (9.6 mmol/l), so this patient must be retested before diagnosis. Patient 3 is diabetic Discussion The glucose calibration graph showed a good linearity which means that Beers Lambert law is obeyed and the results are accurate. In glucose tolerance test (GTT) the patient is asked to eat normally in t he three days leading up to the test and to be fasting for at least 12 hours. At the end of time the patient is asked to collect urine sample and blood sample is collected. After that, the patient drinks 75g of glucose in 300 ml of water within 5 minutes. After 2 hours, the patient is asked to collect anther urine sample and blood sample is collected. Normally when the patient is fasting, the glucose level should be 5.5 mmol/L and there is no glucose in urine. After the patient is given the sugar, the glucose level in the blood will increase, but in the normal person the glucose concentration should go back to normal within 2 hours and no glucose can be detected in urine. What is happening in the normal person after given glucose is that insulin is produced in high concentration, the glucose is converted into glycogen and then the glycogen is stored in the liver. Finally, insulin concentration also decreases to normal concentration. Whereas, in the diabetic patient the glucose leve l stays high because the insulin is insufficient, not produced or present but not functioning due to a defect in the ?-cells of pancreas. In normal condition, the filtered glucose is completely reabsorbed in the proximal tubule. In Diabetes Mellitus the blood glucose is much above the renal threshold (11 mmol/L), reabsorption becomes saturated and it starts to appear in urine. The presence of glucose in urine is called glucosuria. Glucosuria results in osmatic diuresis that increase water excretion and raises the plasma osmolarity, which in turn stimulates the thirst centre. Osmatic diuresis and theist cause classical signs and symptoms of polyuria (large volume of urine) and polydipsia (excessive thirst). In patient-1, fasting blood glucose (4.3 mmol/L) is within the normal range and no glucose in urine. After 2 hours the blood glucose level is 5.8 mmol/L, which is below 7.8 mmol/L and no glucose in the urine. These mean that this patient is normal. In patient-2, fasting b lood glucose is within the normal range and no glucose in urine. After 2 hours the blood glucose level is 8.3 mmol/L which is slightly high but it is within the normal range of impaired glucose tolerance (7.8- 11.1 mmol/l), whereas urine glucose is negative. This means that this patient must be retested before ending to diagnosis of impaired glucose or any other diagnosis. Many people with impaired glucose tolerance progress to develop diabetes, but this condition can be prevented with adoption of a diabetic-type diet and weight loss (if overweight). Whitby, G, et al, (1988). Patient-3 has high fasting blood glucose level (8.2 mmol/L), and in the urine the glucose is not detected. After 2 hours the glucose concentration did not reduce and it went higher up to 14.6 mmol/L. in addition to that, the urine dipstick showed very strong positive reaction (4+), which indicate that this patient is diabetic. In this patient the glucose concentration was high before the sugar was given. Thi s means that there is a defect in insulin secretion which can not breakdown the glucose and bring to the normal level. The high blood glucose level was due to glycogenolysis, gluconeogesis or high glucose intake. Therefore, this patient may have type-1 Diabetes Mellitus. Questions: What facts should be taken in account when interpreting the results of glucose tolerance test? The facts are: Patient should eat normal diet within 3 days before doing the test. The diet should contain at least 250g of carbohydrate. Patient should be fast over night at least 10-12 hours and does not eat during the test. The 75g of glucose should be dissolved in 300 ml of water and then ask the patient to drink it within 5 minutes after collection of fasting blood sample. A pregnant woman should be given less than 75g of glucose as it may affect the baby. If the amount of glucose given is less than recommended, it will affect the result as the Oral Glucose Tolerance Test (OGTT) is standardized procedure. Patient should rest through the test; smoking is not permitted; drink of water is allowed. Blood sample should be collected in container that contains sodium fluoride to inhibit glycolysis. The patient must consult the health care provider if he/she is using medication that can interfere with the test result includes Thiazide diuretics (e.g. hydrochorothiazide), beta-blockers (e.g. prpanolol) oral contraceptive and some psychiatric drugs. There are interfering factors that affect OGTT. There are acute stresses for example, from surgery or infection, and vigorous exercise. Blood glucose rise with age and their renal threshold is increased. Time of sample collection is important (morning). The method we used employed glucose oxidase- name 2 other methods for glucose estimation and describe the principles used. Ortho-toluidine method (mono step): glucose reacts with ortho-toluidine in hot acidic medium to form a green coloured complex. The intensity of the final colour produced is directly proportional to concentration of glucose in the sample. UV-kinetic method: This method also measures the concentration of glucose. The reagent contains ATP, hexokinase, NADP and glucose-6-phosphate dehydrogenase (G6PD) enzme in ethanol amine buffer (PH 7.5). Why HbA1c a better guide to long term diabetes control than glucose? The determination of plasma and urine glucose provides information about the metabolic status only at the moment. Long term control of glucose can be obtained with relative ease by measuring the amount of particular haemoglobin fraction in red blood cells. The glucose enters the red blood cells and binds the haemoglobin to a very small extent. Altho ugh some of the glucose diffuse from the haemoglobin due to formation of covalent bond, but some of the glucose will react with a particular amino acid in the haemoglobin protein. The haemoglobin/glucose complex has different chemical properties from the haemoglobin, thus it can be separated chromatographic or electrophoresis technique. The estimation of Glycosylated haemoglobin (HbA1c) depends on the mean plasma glucose concentration and the life span of red blood cells (RBCs). The normal level of non-diabetic is 6%. Also because it depends on the plasma glucose concentration, HbA1c in diabetic patient tend to be increased over the previous 1- months. The extent of elevation of HbA1c indicates the overall degree of blood glucose control; in poorly controlled diabetes it may rise as high as 25%. Whitby, (1998). So the higher percentage of HbA1c indicates more glucose bound to haemoglobin and hence poor control of diabetic. Subsequently this test is used to asses the quality of the long term control of blood glucose in diabetic patient. Also it examines the patient faithfulness with which he/she followed the health care instruction and the effectiveness of the medication prescribed for treatment.

Essay on Breast Implants - 785 Words

Breast Implants Why do women get breast implants? Do the breast implants make them feel good about themselves? Breast implants are a serious threat because, there are many risks involved, there are many disorders that are possible, and there are illnesses that you could catch after the operation. According to Marian Segal, many of the women who have had breast implants don’t exactly understand what is in their body. Silicone contains organic compounds, which have the physical properties of oils,resins or rubber, and which are more stable when exposed to heat and oxygen thanordinary organic substances. This is the same stuff that goes into your body making you think that you look good ( MS Bookshelf). There are many†¦show more content†¦Measurement of equilibrium swelling of the polymeric component by a good solvent. Determination of the amount of unreached crosslinker from its concentration in the total extractable (ODE documents 6). Pharmacokinetic or biodegradation studies of all materials contained in the finished sterilized device must be reported. Of special concern are questions regarding the ultimate fate , quantities, organs deposition, routes of excretion, and potential clinical significance of silicone shedding, retention, and migration. It would be good if every woman would ask questions about all that information (ODE documents 8). There are also many disorders that are possible. A person can suffer from: general anesthesia, as well as nausea, vomiting and fever. Infection, hemotoma are also possible. (collection of blood that causes: swelling pain and brushing.) Also very dangerous is the skin necrosis- when the tissue dies and blood flow doesn’t get to the skin. This can be caused by smoking, cortisone like drugs, implant that are too large for the available space (Segal 4). Autoimmune-like disorders are disorders which--signs include joint pain and swelling; tightness of the skin, redness or swelling. Swelling of hands and feet are also possible. A rash, swollen glands or lymph nodes; unusual fatigue; general aching. There is also a greater chance of getting colds, viruses and flu. Unusual hair loss,Show MoreRelatedThe Breast Implants Produced By Poly Implant1224 Words   |  5 PagesPIP Implant Scandal 1.0 Background The breast implants produced by Poly Implant Prothese (PIP) French company were banned in the year of 2010. PIP which was founded in year 1991 and was once the world’s third largest supplier of silicone gel breast implants was eventually shut down within the same year. 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Importance of Literature Free Essays

ENG 101 7 February 2012 Importance of Literacy Literature is a creative and imaginative type of writing. It is a source of information that leads to the guiding principles of life. Having the knowledge to read literature attentively and understand it is extremely important. We will write a custom essay sample on Importance of Literature or any similar topic only for you Order Now Literacy is not optional, it is necessary. Literature is not just reading a text but being able to reflect upon it. There are many different types and forms of literacy. Some come in forms of poems and others as dramas or films. Literacy expands towards many varieties. There are children literatures such as â€Å"Winnie the Pooh† and there are also more sacred types of literature such as the scripter’s or Holy Bible. Reading or watching literature gives a person a chance to experience different thoughts towards different situations, it opens a persons mind to imagination. Understanding literature is a sign of intelligence and knowledge. It is not always simple to understand and reflect on literacy. It is important to be open-minded when reading or watching literature. Philosopher Edmund Burke once said, â€Å"Reading without reflecting, is like eating without digesting. † For all means philosopher Burke is one hundred percent correct. The ability to reflect on what is being told shows intelligence, it shows that you have not only read word by word, but you have read the whole piece as one. There are many mistakes that are caused by illiterate people. A perfect example of this concept is the story of a man who was responsible for the death of his son. In the essay â€Å"Hunger in America†, written by Richard Mitchell, Bill Barnhart was charged for certain criminal acts towards his sons death. Barnhart used a passage from the bible for his defense in the case. He believed that in the bible God said that no one should use any medication whatsoever. His son was sick and Barnhart refused to treat his son. His misunderstanding of what was being said cost his sons life. Being literate is extremely important. It can affect everyone around you. Learning literacy is a task that can take a while, but it is not impossible. Reading is extremely important; it is the basics in life. Sense everything requires reading words, the only thing that remains is the reflecting part. Reflecting what you have read shows that you have a clear understanding of what is being said. To be literate does not mean that a person has to read novels and books. It could be simply by reading the news paper, and article, or even a magazine or watching a film. As long as you take time to reflect on the information given and understand what is given, you can read whatever you wish to. Reading or watching literacy gives a person a chance to experience different thoughts towards different situations, it opens a persons mind to imagination. The understanding of literature brings many good things to us, either in science or entertainment. Everything that our world is built on has been based on literacy and continues to do so. Being literate is required to humankind, it is important that we all understand obstacles and situations in life. Literacy allows us to have an idea on how different people live their lives, and it also helps us to understand the purpose in our own life. How to cite Importance of Literature, Papers

Arts Integration Essay Example For Students

Arts Integration Essay The paper must focus on the students understanding on development of a definition of arts integration in at least one art area. (Use at least three reference materials for the paper and use appropriate citations to avoid plagiarism. Arts integration combines curriculum and teaching among dance, music, theatre, and visual art, and interconnects the arts With Nan-arts subjects. Integration takes many forms as teachers from different subject areas collaborate for rich curricular connections. Arts Integration Theory (Back to top) Introduction Arts Integrated Instruction has become an area of great interest over the past decade as schools across the country are discovering the power of the arts when used as a catalyst for teaching across the curriculum. Arts integration is not a substitute for teaching the arts for their own sake, We are champions of art specialists in the schools, and recognize the need to add to their tortes in cities across the country. What is Arts Integration? It is important that all educators become aware of the successes that have been demonstrated when students become engaged in their own learning via arts integrated instruction. Arts integration is not about artist residencies, or occasional arts projects that connect to other curricular subjects. It is about a methodology and a philosophical approach to education that creates a level of personal connection and added depth in the classroom through a creative inquiry-based process of teaching and learning. How do learn more about how to do arts integration? This module in combination with the On-line Expeditions website encourages a layering Of arts integration Within the classroom as students engage in this work. You can access resources in your community, or within your own building reaps, that you didnt know existed before. Possibly the arts specialist(s) in your building would like to explore enhancing the core curriculum with rigorous arts integration. Or maybe you can arrange for professional development training that will introduce arts integration to your faculty in a substantive way. Another option might be to explore how you can bring in professional artists trained in this area to team teach with you in the classroom. Consider checking your state arts council for additional ideas and resources. Its always a good bet that some local theatre or dance troupe has an outreach aerogram that works in schools. Sometimes it is simply a matter of doing some research and inquiring about town. Some organizations also travel. As part of this module you will explore various aspects of the Arts for Learning website, NM. Retraining. Org. You may wish to return to this site for ideas and possible resources in your community. Benefits of an integrative approach An integrative approach to teaching, for example, connects visualization with reading comprehension, conceptualizes math, or brings an experiential context to the science or social studies classroom. Sing the arts can assist students in understanding and applying skills to standardized exams. Focus and concentration can be developed through an appreciation and application of different learning styles, such as linguistic, visual or kinesthesia thinking. Through the connection of personal experience with the subject matter, and an emphasis on the process Of discovery Which allows for unexpected outcomes, teachers help students to develop more complex thinking skills. Through the integration of perception into cognition, and expression into reflection, students perform at a significantly higher level. While this module Will focus on arts integrated activities oh can do yourself, know that having artists team teach in classrooms alongside teachers is an ideal model for truly integrated instruction, Research, Results, and Resources Critical Links and Champions of Change There has been much research on the work of arts integrated instruction and the value of arts in teaching and learning. Serial Killer Mind EssayAdvocates for the arts often use photographs of smiling faces to document the experience. But in a society that values measurements and uses data-driven analysis to inform decisions about allocation of scarce resources, photographs Of smiling faces are not enough to gain or even retain support. Such images alone will not convince skeptics or even neutral decision-makers that something exceptional is happening when and where the arts become part of the lives of young people. Until now, weve known little about the nature of this change, or how to enable the change to occur. To understand these issues in more rigorous terms, we invited leading educational researchers to examine the impact of arts experiences on young people. We developed the Champions of Change: The Impact of the Arts on Learning initiative in cooperation with The Arts Education Partnership and The Presidents Committee on the Arts and Humanities to explore why and how young people were changed through their arts experiences. Executive Summary As a result of their varied inquiries, the Champions of Change researchers found that learners can attain higher levels of achievement through their engagement with the arts Moreover, one of the critical research findings is that the learning in and through the arts can help level the playing field for youngsters from stagnated circumstances Why the Arts Change the Learning Experience When well taught, the arts provide young people with authentic learning experiences that engage their minds, hearts, and bodies. The learning experiences are real and meaningful for them. While learning in other disciplines may often focus on development Of a singled skill or talent, the arts regularly engage multiple skills and abilities. Engagement in the artswhether the visual arts, dance, music, theatre or Other disciplines-?nurtures the development of cognitive, social, and personal competencies. Although the Champions of Change researchers conducted their investigations and presented their findings independently, a remarkable consensus exists among their findings: The arts reach students who are not otherwise being reached. The arts reach students in ways that they are not otherwise being reached. The arts connect students to themselves and each other. The arts transform the environment for learning. The arts provide learning opportunities tort the adults in the lives of young people. The arts provide new challenges for those students already considered successful. The arts connect learning experiences to the world to real work.