DEFINITION

It is an analysis that is conducted separately or in a general request in the blood biochemistry.

Measures the amount (concentration) of glucose in the blood.

Glucose is a sugar that is used by the tissues as a form of energy when combined with oxygen breathing. When we eat sugar in the blood rises, which is consumed away from the blood, this is a regulatory hormone insulin is produced by the pancreas (pancreatic islets). This hormone makes the blood glucose from the tissue and is used in the form of glycogen, amino acids and fatty acids. When blood glucose is very low under normal conditions by fasting, the other is secreted hormone called glucagon which does the opposite, keeping blood glucose levels.

The tissue most sensitive to changes in blood glucose is the brain in very low concentrations or very high symptoms of mental confusion and unconsciousness.

WHAT IS THIS STUDY?

The analysis of glucose is mainly to study the possible presence of diabetes mellitus or saccharin. As it is a very complex disease and major health impact analysis is a very discriminative and useful is made fairly routine.

TECHNICAL REALIZATION

To perform this analysis needs to be fasting at least 6 hours prior.

Impossible to take an appropriate place (see, clinic, hospital) but sometimes is done in the patient’s home.

* To make the taking is necessary to locate a suitable vein and the veins are generally used in the flexure of the elbow. The person taking the sample used medical gloves, a needle (with a syringe or tube removal).
* We will tortor a (rubber band-latex) in the arm to retain more blood veins and appear more visible and accessible.
* Clean the area with an antiseptic and a puncture through a vein located palpation and appropriate access to it with the needle. We drop the tortor.
* When the blood flows through the needle aspiration done on health (by syringe or by applying a vacuum tube).
* At the end of the outlet, the needle is removed and the area is pressed with a cotton swab or something similar to promote clotting and you will be asked to bend your arm and hold down the area with a plaster for a few hours.

PROBLEMS AND POTENTIAL RISKS

1. The acquisition by a puncture of the vein can cause some pain.
2. The potential difficulty in finding suitable vein can lead to multiple punctures
3. Appearance of a hematoma (bruising or Cardinal) in the quarry area, usually due to the vein has not been closed after the pressure well and has continued after leaving blood causing this problem. You can apply an ointment or type Hirudo ® ® Trombocid in the area.
4. Inflammation of the vein (phlebitis), sometimes the vein is altered, either by a purely physical cause or has been infected. The area should be kept relaxed few days and you can apply an ointment or type Hirudo ® ® Trombocid in the area. If the problem persists or fever should consult your doctor.

NORMAL VALUES IN BLOOD SUGAR

Normal values are between 70 and 105 mg per deciliter. In young children are accepted values of 40 to 100 mg / dl.

The lower values of 40-50 mg / dl are considered low (hypoglycemia).

The highest values of 128 mg / dl are considered high (hyperglycaemia).

Can modify the values of glycemia and diabetes but for certain situations:

1. Acute stress (stroke, cardiac, general anesthesia)
2. The serum treatment in vein as they contain dextrose (sugar)
3. Pregnancy
4. Medications (antidepressants, antihypertensives, female hormones, etc …)
5. Alcohol and analgesics may decrease.

DIAGNOSTIC POTENTIAL IN abnormal values of blood glucose

You can see the increased blood glucose (hyperglycemia) in:

* Diabetes mellitus
* Renal
Pheochromocytoma *
Hyperthyroidism *
* Glucagonoma
Acute pancreatitis *
* Cushing’s Syndrome
Pancreatic Neoplasms *
* Other conditions explained before (stress, sera, pregnancy, drugs)

Decreased blood glucose may occur (hypoglycemia) in:

* Diets excessive
Liver Diseases *
* Addison’s Disease
* Excess insulin in diabetic
* Hipopitituarismo
Hypothyroidism *
* Insulinoma

DEFINITION

Today all of the insulin market are synthesized human insulin by genetic engineering (recombinant DNA). Insulins of bovine or swine have virtually disappeared from the market. All are highly purified and contain only protein of insulin and other non-contaminated. The single factor that differentiates them is the duration of action.

As the insulin is active only in the blood for short periods (less than 15 minutes), have used various ways to delay its release and its action.

These systems are based on injectable preparations that retard the release:

* By binding to other proteins (protamine).
* By a crystallization: Zinc is added as the particles are made larger slow-soluble, so it will be released gradually.

Depending on the system delay of its action insulins can be fast, intermediate and slow.

All insulins should be injected subcutaneously delayed, and delayed not only can be given intravenous route.

Administration of insulin

The usual route of administration is subcutaneous insulins. Exceptionally (diabetic coma) is used to track IV.

The most common method of administration is using special syringes graduated in units of insulin. Devices have achieved acceptance in the form of injector pen, which provide various schemes shots a day.

There are also pre-filled syringes can accurately measure in increments of 2 IU and tiles for various applications (changing the needle).

The pumps that run on a quota of a basal insulin dose via SC, supplemented by extra doses before meals. Are less widely used: they are especially useful for highly motivated patients. Are ascribed to a certain increase in frequency of episodes of ketoacidosis, possibly related to a malfunction.

The Spanish insulin syringe for administration are standardized to the dose of 40 IU / ml in 10 ml vials. Cartridges for pumps and injectors have a concentration of 100 IU / ml and the volume is adjusted to the specifications of the device.

Dosage

The spread of the idea that the strict control of blood glucose can prevent long-term complications of diabetes (recently demonstrated by clinical trials) has created a tendency to use dosing regimen designed to align as closely as possible to the administration insulin to the diurnal variations in blood glucose.

This involves several regimens of daily injections and blood glucose control by the patient. The patterns most frequently used at present are:

* Two doses (before breakfast and evening) of a mixture of intermediate insulin and insulin quickly. The popularity of this scheme explains the spread of biphasic insulin preparations.
* A daily dose of long-acting insulin (morning or evening, sometimes replaced by a dose of intermediate insulin at bedtime) and three insulin injections a day fast before the main meals. The drawback of this regime decreases if you use a pen type injector. We need motivated patients, but has the advantage of allowing a more flexible mealtimes.

FUNDING FOR THE NATIONAL SYSTEM OF HEALTH

All insulins are prescribed by Social Security.

With regard to the application equipment, syringes and needles can not be dispensed through pharmacies but are distributed free in primary care and outpatient care.

As a general rule do not repay the SS insulin pump or pen injection equipment type. Some areas of health can do so only occasionally, depending on budget availability. The needles of the equipment can be obtained free of charge in primary care.

Injection equipment in the form of pre-filled syringe are considered medicinal products and are prescribed as such. The needles are being distributed free in primary care.

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