-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
*For reference only for medical professionals Diabetes is a group of metabolic diseases characterized by hyperglycemia
.
Hyperglycemia is caused by defective insulin secretion, impaired biological action, or both
.
Long-term hyperglycemia leads to chronic damage and dysfunction of various tissues, especially the eyes, kidneys, heart, blood vessels, and nerves
.
Diabetes indicators are important references for the diagnosis of the disease, the judgment of the condition, and the formulation of individualized treatment plans
.
Factors Affecting Blood Glucose Testing Before understanding the various testing indicators, we must first know that collecting blood that meets the requirements is the key
.
The capillary blood glucose of the household blood glucose meter is generally used for daily blood glucose monitoring of diabetic patients, and cannot be used for the diagnosis of diabetes.
The diagnosis needs to detect the glucose content in venous plasma (or serum)
.
Long-term tension and anxiety, insomnia before blood drawing, some diseases or stress states such as colds, inflammations, acute infections, trauma, etc.
, may lead to high fasting blood sugar, resulting in transient "stress hyperglycemia"
.
Before measuring blood sugar, we must rule out such situations, so that the test results can truly reflect your own blood sugar level; some drugs such as vitamin C will affect the blood sugar test results
.
Vitamin C is a reducing agent, which may chemically react with the reagents for testing blood sugar and urine sugar, which may cause deviations in the results of blood sugar and urine sugar testing.
Therefore, we must consider the influence of drugs before testing blood sugar
.
Standard Oral Glucose Tolerance Test (OGTT) Standard Oral Glucose Tolerance Test (OGTT) is a common test used to diagnose diabetes.
Fasting blood glucose and postprandial blood glucose values can be obtained through the test to understand islet β-cell function and the body's ability to regulate blood sugar.
It is a confirmatory test for the diagnosis of diabetes and is widely used in clinical practice
.
Detection method: After 8-10 hours of fasting overnight, draw venous blood before 8:00 in the morning to obtain the fasting blood glucose value; then take an aqueous solution made of 75 grams of anhydrous glucose and 250-300 ml of water, and start timing from the first sip , respectively extract the blood glucose values at several time points such as 30min, 60min, 2h, 3h, and the fasting blood glucose value to form the blood glucose value at 5 time points for inspection
.
Table 1 The corresponding normal range values of OGTT detection (units are mmol/L) of glycosylated hemoglobin (HbA1c) in the 2020 edition of "China's Guidelines for the Prevention and Treatment of Type 2 Diabetes", HbA1c measured under the standardized method is used as a supplementary diagnostic standard for diabetes
.
HbA1c is the HbA1c formed by the combination of some special molecular parts of hemoglobin and glucose through a slow and irreversible non-enzymatic reaction
.
The normal reference value of HbA1c is 4%~6%
.
It should be noted that: HbA1c reflects the average level of blood sugar control in the recent period of time, and does not reflect the fluctuation of blood sugar.
A normal HbA1c does not mean that there is no problem with blood sugar.
Anemia, abnormal hemoglobin and other factors may affect the accuracy of the results.
cause an impact
.
Time in Range (TIR) In 2020, the American Diabetes Association (ADA) released a new standard for evaluating blood sugar control in the "Medical Standards of Diabetes" released by the American Diabetes Association (ADA).
Time in Range (TIR) , and also made relevant recommendations in the newly released "China Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition)", taking TIR as a new target for blood sugar control
.
According to the "TIR International Consensus Recommendations", TIR refers to the time (min) or the percentage (%) of the blood glucose within the target range (usually 3.
9-10.
0 mmol/L) within 24 hours of a day for diabetic patients
.
Usually, diabetic patients are required to control their blood sugar between 3.
9 and 10 mmol/L for more than 70% of the time in 24 hours a day, which is considered to be the blood sugar control standard.
However, it should be highly individualized, and attention should be paid to hypoglycemia and blood sugar fluctuations
.
The significance of TIR lies in understanding blood glucose homeostasis and the guarantee and regulation of blood glucose homeostasis, which can more accurately prevent the occurrence of various diabetic complications in patients and effectively control the progression of the disease
.
Commonly used blood glucose assessment indicators in clinical practice, including blood glucose and HbA1c, all have certain limitations and cannot describe whether the daily blood glucose fluctuations of patients are within the normal range.
One is too microscopic and the other is too macroscopic
.
The organic combination of blood glucose, HbA1c and TIR, which is an ideal blood glucose monitoring mode, can reflect the real situation of the patient's blood sugar control more comprehensively, and provide sufficient decision-making basis for fine adjustment of the treatment plan
.
Glycated albumin (GA) GA is the product of the non-enzymatic reaction between serum proteins (mainly albumin) and glucose, because the half-life of albumin is 17 to 20 days, and GA reflects the average level of blood glucose in the 2 to 3 weeks before the measurement
.
GA is quantitatively determined on the basis of GSP (glycated serum protein).
The percentage of serum GA and serum albumin is used to represent the level of GA, and the influence of serum albumin level on the test results is removed, so it is more accurate than GSP
.
The reference range of GA normal value is 11%~17%
.
Compared with HbA1c, GA is more sensitive to short-term changes in blood glucose than HbA1c, and is a good indicator for evaluating short-term glucose metabolism control in patients, especially for diabetic patients after adjustment of the treatment plan.
.
In addition, for diabetic patients with factors affecting the lifespan of red blood cells, HbA1c value measurement is often underestimated.
At this time, GA is suitable for selection, and the value is not affected.
GA can better reflect blood sugar control than HbA1c
.
Urine Glucose Urine Glucose refers to the sugars in the urine, mainly referring to the glucose in the urine
.
Normal people have very little urine sugar and cannot be detected by general methods, so normal people's urine sugar should be negative, or there should be no sugar in the urine
.
Only when the blood sugar exceeds 160 ~ 180mg/dl, the sugar can be excreted from the urine to form urine sugar
.
Under normal circumstances, the glomerulus of the kidney has a strong ability to reabsorb glucose, but this ability is limited.
When the blood glucose concentration exceeds the glucose threshold of the kidney (usually 8.
9~10.
0mmol/L), the glucose will follow Urine is excreted, showing positive urine sugar, which can indirectly reflect blood sugar level
.
Generally speaking, there is the following empirical correspondence between "urine sugar+" and "blood sugar": Table 2 Correspondence between "urine sugar+" and "blood sugar" ▎ Note: positive urine sugar cannot be used to diagnose diabetes
.
Whether there is a "+" in urine sugar is related to the blood sugar concentration, whether the renal glucose threshold is increased or decreased, stress factors and other diseases.
Several conditions of "disease-related diabetes mellitus"
.
Urinary ketone bodies Urinary ketone bodies are the general term for three different components, which are acetone, acetoacetic acid and β-hydroxybutyric acid, which are intermediate products of fat metabolism in the body
.
Under normal circumstances, it produces very little, and the qualitative test of normal ketone bodies is negative
.
In the case of starvation, impaired glucose metabolism, increased lipolysis and diabetic acidosis caused by various reasons, the rate of ketone body production is greater than the rate of tissue utilization, and ketosis may occur, followed by ketonuria.
At this time, the situation is not optimistic.
, you should go to the hospital for medical treatment in time to avoid unnecessary injuries
.
Severely diabetic patients are unable to metabolize carbohydrates to provide energy for the body due to the severe lack of insulin in the body.
In order to maintain normal physiological functions, the body will consume fat and produce a large number of ketone bodies to accumulate in the blood, causing diabetic ketoacidosis and 2 urine ketone bodies.
+” above can be used as reference diagnostic criteria for ketoacidosis
.
Insulin autoantibodies appear in two cases, one appears in patients receiving exogenous insulin treatment, which is mainly related to the purity of insulin preparations, and the other appears in patients who have never received insulin treatment, called insulin itself antibody
.
Insulin antibodies are very important for the diagnosis, differential diagnosis and treatment of diabetes and hypoglycemia
.
Early detection of type 1 diabetes: Normal people may have type 1 diabetes if they find insulin antibodies in their blood
.
Detection of insulin autoantibodies can be used as a marker of autoimmune islet cell damage and can be used for early detection and prevention of type 1 diabetes
.
Diagnose insulin resistance and guide diabetes treatment: the presence of insulin antibodies in the blood is an important cause of insulin resistance.
In the process of using insulin therapy, diabetic patients may develop insulin resistance due to the production of insulin antibodies.
Not ideal
.
Insulin antibodies should be detected at this time, if positive or increased titer can be used as an objective basis for insulin resistance
.
.
Hyperglycemia is caused by defective insulin secretion, impaired biological action, or both
.
Long-term hyperglycemia leads to chronic damage and dysfunction of various tissues, especially the eyes, kidneys, heart, blood vessels, and nerves
.
Diabetes indicators are important references for the diagnosis of the disease, the judgment of the condition, and the formulation of individualized treatment plans
.
Factors Affecting Blood Glucose Testing Before understanding the various testing indicators, we must first know that collecting blood that meets the requirements is the key
.
The capillary blood glucose of the household blood glucose meter is generally used for daily blood glucose monitoring of diabetic patients, and cannot be used for the diagnosis of diabetes.
The diagnosis needs to detect the glucose content in venous plasma (or serum)
.
Long-term tension and anxiety, insomnia before blood drawing, some diseases or stress states such as colds, inflammations, acute infections, trauma, etc.
, may lead to high fasting blood sugar, resulting in transient "stress hyperglycemia"
.
Before measuring blood sugar, we must rule out such situations, so that the test results can truly reflect your own blood sugar level; some drugs such as vitamin C will affect the blood sugar test results
.
Vitamin C is a reducing agent, which may chemically react with the reagents for testing blood sugar and urine sugar, which may cause deviations in the results of blood sugar and urine sugar testing.
Therefore, we must consider the influence of drugs before testing blood sugar
.
Standard Oral Glucose Tolerance Test (OGTT) Standard Oral Glucose Tolerance Test (OGTT) is a common test used to diagnose diabetes.
Fasting blood glucose and postprandial blood glucose values can be obtained through the test to understand islet β-cell function and the body's ability to regulate blood sugar.
It is a confirmatory test for the diagnosis of diabetes and is widely used in clinical practice
.
Detection method: After 8-10 hours of fasting overnight, draw venous blood before 8:00 in the morning to obtain the fasting blood glucose value; then take an aqueous solution made of 75 grams of anhydrous glucose and 250-300 ml of water, and start timing from the first sip , respectively extract the blood glucose values at several time points such as 30min, 60min, 2h, 3h, and the fasting blood glucose value to form the blood glucose value at 5 time points for inspection
.
Table 1 The corresponding normal range values of OGTT detection (units are mmol/L) of glycosylated hemoglobin (HbA1c) in the 2020 edition of "China's Guidelines for the Prevention and Treatment of Type 2 Diabetes", HbA1c measured under the standardized method is used as a supplementary diagnostic standard for diabetes
.
HbA1c is the HbA1c formed by the combination of some special molecular parts of hemoglobin and glucose through a slow and irreversible non-enzymatic reaction
.
The normal reference value of HbA1c is 4%~6%
.
It should be noted that: HbA1c reflects the average level of blood sugar control in the recent period of time, and does not reflect the fluctuation of blood sugar.
A normal HbA1c does not mean that there is no problem with blood sugar.
Anemia, abnormal hemoglobin and other factors may affect the accuracy of the results.
cause an impact
.
Time in Range (TIR) In 2020, the American Diabetes Association (ADA) released a new standard for evaluating blood sugar control in the "Medical Standards of Diabetes" released by the American Diabetes Association (ADA).
Time in Range (TIR) , and also made relevant recommendations in the newly released "China Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition)", taking TIR as a new target for blood sugar control
.
According to the "TIR International Consensus Recommendations", TIR refers to the time (min) or the percentage (%) of the blood glucose within the target range (usually 3.
9-10.
0 mmol/L) within 24 hours of a day for diabetic patients
.
Usually, diabetic patients are required to control their blood sugar between 3.
9 and 10 mmol/L for more than 70% of the time in 24 hours a day, which is considered to be the blood sugar control standard.
However, it should be highly individualized, and attention should be paid to hypoglycemia and blood sugar fluctuations
.
The significance of TIR lies in understanding blood glucose homeostasis and the guarantee and regulation of blood glucose homeostasis, which can more accurately prevent the occurrence of various diabetic complications in patients and effectively control the progression of the disease
.
Commonly used blood glucose assessment indicators in clinical practice, including blood glucose and HbA1c, all have certain limitations and cannot describe whether the daily blood glucose fluctuations of patients are within the normal range.
One is too microscopic and the other is too macroscopic
.
The organic combination of blood glucose, HbA1c and TIR, which is an ideal blood glucose monitoring mode, can reflect the real situation of the patient's blood sugar control more comprehensively, and provide sufficient decision-making basis for fine adjustment of the treatment plan
.
Glycated albumin (GA) GA is the product of the non-enzymatic reaction between serum proteins (mainly albumin) and glucose, because the half-life of albumin is 17 to 20 days, and GA reflects the average level of blood glucose in the 2 to 3 weeks before the measurement
.
GA is quantitatively determined on the basis of GSP (glycated serum protein).
The percentage of serum GA and serum albumin is used to represent the level of GA, and the influence of serum albumin level on the test results is removed, so it is more accurate than GSP
.
The reference range of GA normal value is 11%~17%
.
Compared with HbA1c, GA is more sensitive to short-term changes in blood glucose than HbA1c, and is a good indicator for evaluating short-term glucose metabolism control in patients, especially for diabetic patients after adjustment of the treatment plan.
.
In addition, for diabetic patients with factors affecting the lifespan of red blood cells, HbA1c value measurement is often underestimated.
At this time, GA is suitable for selection, and the value is not affected.
GA can better reflect blood sugar control than HbA1c
.
Urine Glucose Urine Glucose refers to the sugars in the urine, mainly referring to the glucose in the urine
.
Normal people have very little urine sugar and cannot be detected by general methods, so normal people's urine sugar should be negative, or there should be no sugar in the urine
.
Only when the blood sugar exceeds 160 ~ 180mg/dl, the sugar can be excreted from the urine to form urine sugar
.
Under normal circumstances, the glomerulus of the kidney has a strong ability to reabsorb glucose, but this ability is limited.
When the blood glucose concentration exceeds the glucose threshold of the kidney (usually 8.
9~10.
0mmol/L), the glucose will follow Urine is excreted, showing positive urine sugar, which can indirectly reflect blood sugar level
.
Generally speaking, there is the following empirical correspondence between "urine sugar+" and "blood sugar": Table 2 Correspondence between "urine sugar+" and "blood sugar" ▎ Note: positive urine sugar cannot be used to diagnose diabetes
.
Whether there is a "+" in urine sugar is related to the blood sugar concentration, whether the renal glucose threshold is increased or decreased, stress factors and other diseases.
Several conditions of "disease-related diabetes mellitus"
.
Urinary ketone bodies Urinary ketone bodies are the general term for three different components, which are acetone, acetoacetic acid and β-hydroxybutyric acid, which are intermediate products of fat metabolism in the body
.
Under normal circumstances, it produces very little, and the qualitative test of normal ketone bodies is negative
.
In the case of starvation, impaired glucose metabolism, increased lipolysis and diabetic acidosis caused by various reasons, the rate of ketone body production is greater than the rate of tissue utilization, and ketosis may occur, followed by ketonuria.
At this time, the situation is not optimistic.
, you should go to the hospital for medical treatment in time to avoid unnecessary injuries
.
Severely diabetic patients are unable to metabolize carbohydrates to provide energy for the body due to the severe lack of insulin in the body.
In order to maintain normal physiological functions, the body will consume fat and produce a large number of ketone bodies to accumulate in the blood, causing diabetic ketoacidosis and 2 urine ketone bodies.
+” above can be used as reference diagnostic criteria for ketoacidosis
.
Insulin autoantibodies appear in two cases, one appears in patients receiving exogenous insulin treatment, which is mainly related to the purity of insulin preparations, and the other appears in patients who have never received insulin treatment, called insulin itself antibody
.
Insulin antibodies are very important for the diagnosis, differential diagnosis and treatment of diabetes and hypoglycemia
.
Early detection of type 1 diabetes: Normal people may have type 1 diabetes if they find insulin antibodies in their blood
.
Detection of insulin autoantibodies can be used as a marker of autoimmune islet cell damage and can be used for early detection and prevention of type 1 diabetes
.
Diagnose insulin resistance and guide diabetes treatment: the presence of insulin antibodies in the blood is an important cause of insulin resistance.
In the process of using insulin therapy, diabetic patients may develop insulin resistance due to the production of insulin antibodies.
Not ideal
.
Insulin antibodies should be detected at this time, if positive or increased titer can be used as an objective basis for insulin resistance
.
