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Regulation of blood glucose concentration: Glucose α - glycosidase Glycogen Glucose -1- phosphate Phosphoglucomutase G-6-Phosphatase Hexokinase Glucose -6- phosphate Glucose Glucose Glycolysis Pyruvate Co2 Amino acid Acetyl-Co A Proteins Citric acid cycle Krebs cycle 1 Fatty acid There are many hormones associated with the regulation of blood glucose concentration:1-Insulin: the mechanisms of action are:a- stimulate glycogenesis and lipogenesis(The formation of lipid from glucose) b- Prevent or reduce the formation of glucose from other sources which mean prevent the process (gluconeogenesis). c- Increased the permeability of the cells to glucose. d- Increased the ability of the body and the cells to metabolize the carbohydrates. 2-Growth hormone and Adrenocortico trophic hormone:Increase blood glucose due to antagonizing action to insulin. 3-Hydrocortisone: increase blood glucose due to gluconeogenesis. 4-Epinephrine: - Increase blood glucose due to stimulating of glycogenolysis. 5-glucagon: act as Epinephrine 6-Thyroxine: act as Epinephrine What are type 1 and type 2 diabetes Type 2diabetes is the most common form, it appears most often in middle-aged adults however, adolescents and young adults are developing type 2 diabetes at an alarming rate. It develops when the body doesn't make enough insulin and doesn’t efficiently use the insulin it makes (insulin resistance). Type 1 diabetes usually occurs in children and young adults. In type 1 diabetes the pancreas makes little or no insulin. Without daily injections of insulin, people with type 1 diabetes won't survive. Both forms of diabetes can significantly increase the risk of developing diabetes .Untreated diabetes can lead to many serious medical problems. 2 Why should be blood sugar levels controlled? (Diabetic complications) When very high levels of blood glucose are present for years, it leads to damage of the small blood vessels. This in turn increases your risk of developing latestage diabetes mellitus complications including: - retinopathy (eye disease ) - nephropathy (kidney disease) - neuropathy (nerve disease) - cardiovascular disease, such as heart attack, hypertension, heart failure, stroke Blood glucose tests are done to: - Checking for diabetes - Monitor treatment of diabetes - Checking for diabetes that occurs during pregnancy (gestational diabetes) - Determine if an abnormally low blood sugar level (hypoglycemia) is present. What is the Oral Glucose Tolerance Test? Oral Glucose Tolerance Test (OGTT) measures the body's ability main sourse of energy .An OGTT can be used to diagnose prediabetes and diabetes . An OGTT is most commonly done to check for diabetes that occurs with pregnancy, Gestational diabetes. 3 Why it is done? - Checking pregnant woman for gestational diabetes. When done for this purpose, the test called glucose challenge screening test, and it is usually done during the 24th to the 28th week of pregnancy. - Have had gestational diabetes during a previous pregnancy. - Are younger than age 25 and were overweight before getting pregnant. - Confirm the presence of gestational diabetes if other blood glucose measurements are high. - Diagnosing prediabetes and diabetes. How it is done: - You will be asked to drink a sweet liquid containing glucose. it is best to drink the liquid quickly - A blood sample will be collected 30, 60, 90, and 120 Min. after drinking the glucose solution. Normally, blood glucose levels peak within an hour and then begin to drop. Urine glucose: When abnormal values of glucose are found during a urine test, further investigation is required to ascertain your health status. Using a urine test is a quick and inexpensive way to check for glucose in your urine, and is one of our test kit products that can be done in the privacy of your home. Glucose appear in the urine when the level of blood glucose arise to over than 180 mg/dL (which is called glucose renal threshold) .Sometimes glucose appeared in the urine before reaching real threshold because of the neonatal defect in kidney or after taking a large amount of carbohydrates or after stress due to adrenalin secretion also during pregnancy. 4