(1) examination of the severity or control of abnormal glycometabolism
1. Glucose oxidase method was used to determine urine glucose, and positive urine glucose was an important clue in the diagnosis of diabetes. A positive urine glucose level only indicates a blood glucose level above the renal glucose threshold (about 10 mmol/L) , so a negative urine glucose level does not rule out diabetes. When complicated with renal disease, the renal sugar threshold rises, although the blood sugar rises, but the urine sugar is negative. When the renal sugar threshold decreases during pregnancy, although the blood sugar is normal, the urine sugar can be positive.
2. The measurement of blood glucose and the increase of OGTT blood glucose are the main basis for the diagnosis of diabetes, and also the main index for judging the condition and control of diabetes. The blood sugar value reflects the instantaneous blood sugar condition. Determination of glucose by glucose oxidase method. Take venous blood or capillary blood. Plasma, serum, or whole blood may be used. If the hematocrit is normal, plasma and serum glucose can be increased by 15% . Blood glucose must be measured with venous plasma in the diagnosis of diabetes, and a portable glucose meter (capillary) may be used during follow-up of glucose control during treatment. When the blood glucose is higher than the normal range and not up to the diagnostic standard of diabetes, 0GTT should be performed. 0GTT should be taken on an empty stomach in the morning and taken orally by adults. 75 g anhydrous glucose or 82.5 g glucose containing one molecule of water, dissolved in 250 ~ 300 RNL water, finished within 5 ~ 10 minutes, fasting and 2 hours after starting drinking glucose water. The amount of sugar taken by children is calculated at 1.75 g/kg body weight, and the total dose does not exceed 75 g.
3. Glycated hemoglobin and glycosylated plasma albumin determination GHBAL is the product of a non-enzymatic reaction of glucose or other sugars with the amino group of hemoglobin (an irreversible glycosylation of the protein) , most positively related to blood glucose concentration. There are three kinds of GHbAl: A, B and C, with GHBALC (A1C) being the most important. A1C in normal subjects accounted for 3% ~ 6% of the total hemoglobin, and the reference value of A1C was different in different laboratories. A1C increased in subjects with poor blood glucose control and was correlated with the degree of blood glucose elevation. Because the red blood cell’s life span in blood circulation is about 120 days, HBA1C reflects the total blood sugar level of the patients from 8 to 12 weeks, which is one of the main monitoring indexes of diabetes control. Plasma proteins (mainly albumin) can also form fructosamine (FA) by nonenzymatic glycosylation of glucose, and the amount of FA is related to blood glucose concentration, the normal value is 1.7 ~ 2.8 mmol/i. Because the concentration of albumin in blood is stable and the half-life is 19 days, FA can reflect the total blood sugar level of patients within 2 ~ 3 weeks.
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