1. Glucose, quantitative determination

2. Hormonal regulation of blood glucose

3. Methods
Chemical
Enzymatic

6. CHEMICAL METHODS Oxidation - Reduction Methods Condansation Methods
Folin – Wu
Somogyi - Nelson
Condansation Methods
Orto - Toluidine

7. Benedict reaction

8. Glucose + Cu2+ >>>Gloconate + Cu+
Folin - Wu
Glucose + Cu2+ >>>Gloconate + Cu+
pH > 7 , heat
Cu+ + phosphomolybdate
Blue molybdenium complex
λ = 660 nm

9. Glucose + Cu2+ >>> Gloconate + Cu+
Somogyi - Nelson
Glucose + Cu2+ >>> Gloconate + Cu+
pH > 7 , heat
Cu+ + arsenomolybdate >>> blue molybdenium complex
λ = 660 nm

10. O - Toluidine Method
o - Toluidine + Glucose >>> Glycosylamine
pH < 7 , heat
Schiff Base
λ = 630 nm color complex
NH2
CH3

12. Interference
Bilirobin
Galactose
Mannose
Hemoglobin

13. Enzymatic Methods
Glucose Oxidase
Hexokinase
Glucose dehydrogenase

14. Glucose Oxidase α -D-Glucose β-D-Glucose O2 Gluconic acid + H2O2
Mutarotase
α -D-Glucose β-D-Glucose O2
glucose oxidase
Gluconic acid + H2O2
Peroxidase
H2O2 + chromogen Color complex
(o-dianisidine) H2O
(phenylamine) λ = 520 nm

15. Glucose oxidase Inhibited by
High concentrations of uric acid, ascorbic acid, bilirubin, glutathione, creatinine. L-cysteine, L-dopa. Dopamine, methyldopa and citric acid

16. Hexokinase method

17. Glucose dehydrogenase method

18. Clinical Significance
F.B.S (Fasting Blood Suger)
Fasting hours
Normal Range mg/dL
Decrease
Hypoglycemia
Increase
Hyperglycemia

19. Criteria for the diagnosis of diabetes mellitus

20. Diagnosis of Pre-Diabetes and Diabetes Mellitus

21. Hyperglycemia FBS > 140 mg/dL Primary (Diabetes Mellitus)
IDDM (type I)
NIDDM (type II)

22. Insulin Dependent Diabetes Mellitus (IDDM)
Absolute deficiency of insulin
Make up about 10% of all patients with D.M.
IDDM persent at an early age (usually before 30)
Clinical signs :
Blood glucose
Insulin (decreased)
Ketosis
Loss of body weight

23. Noninsulin Dependent Diabetes Mellitus (NIDDM)
Deficiency of insulin receptor
Patients are commonly obese
NIDDM is the most common from of D.M. ( 80-90%)
Usually first present at an age over 40
Clinical signs
Blood glucose
Insulin
Osmotic diuresis
Dehydration

24. Characteristics of Type 1 and Type 2 Diabetes

25. Response of plasma insulin to glucose stimulation

26. Secondary hyperglycemia
Pancratectomy
Acromegaly
Cushing’s syndrome
Glucagonoma

27. Hypoglycemia Adult < 45 - 50 mg/dL in fasting Infant
Preterm < 25 mg/dL
Fullterm < 35 mg/dL

28. Causes of hypoglycemia
Insulinoma (islet cell tumors)
Glycogen Storage Diseases (GSD)
Addison’s disease

29. OGTT
Fasting 80 mg/dL
mg/dL
mg/dL
mg/dL
mg/dL

30. Oral Glucose Tolerance Tests (OGTT)

31. Screening and diagnosis of gestational diabetes mellitus

32. OGTT curve

33. 2hpp 2hpp (two hours postprandial plasma glucose)
To screen for diabetes mellitus
To monitor glucose control

34. Glycated hemoglubin
HbA1c

35. an index of average blood glucose levels over the past 2-4 months.
People without diabetes have HbA1c levels between 4-6%.
Measure HbA1C levels every 3-6 months to monitor glycemic control

40. Put 10 minute in boil water bath
read at 630 nm
Ct = At / Ast * Cst