Testing of Sugar

Various Diabetes detection and education programmes have changed the thinking of general population. Now they believe that early diagnosis of Diabetes and its control can make their life comfortable, free from the complications of Diabetes. There are various methods to diagnose Diabetes. These are:

• Urine Examination for sugar.
• Blood test for glucose

Urine Examination

Urine can be tested for glucose at home or in laboratory by stick method or by Benedicts test.

Test by Glucostrips

This is simple procedure, various companies make strips. There is a chemical at the end of strip which when comes in contact with urine sugar/glucose changes its colour. One can read and compare the colours with the colours displayed at strip bottle.

How to do it

1. Collect urine in small container an dip the strip in it for a few seconds or one can dip the strip in stream while passing urine.
2. Shake and clean the strip to remove the excess amount of urine on it.
3. After one minute compare the colour of strip with the colours depicted at bottle.

Results

From the strip it will become clear whether one is having sugar or not. +, ++, ++++ of sugar or 0.5%, 1%, 1.5% or 2%.

Depending upon the colour of strip from

• Blue
• Dark Green
• Yellow-Green
• Brown
• Orange.

It is not essential that all Diabetic patients will pass sugar in urine. If Blood Sugar is not more than 180 mg, 100 ml of Blood Sugar will not appear in urine.

Excessive intake of Vita-C/Asprin or Aldomet tablets can give false results, i.e. if person is taking the above medicines his urine may not reveal correct picture.

With Benedict Test

Urine is heated with Benedict solution and change in colour is observed. Depending upon the colour of mixture - If it is Blue, Dark Green, Yellow Green, Orange. Strips for ketone are also available, IDDM patients urine should be tested for Ketones in urine.

Urine testing for sugar can be done 3-4 times a day in a patient who is using insulin to monitor the dose of Insulin.

Blood Sugar Estimation

For Blood Sugar estimation now-a-days there are computerised equipment available which can give the results within few minutes.

Blood Sugar estimation can be done

A. Fasting Blood Sugar
B. Post Prandial
C. Random

Fasting Blood Sugar is usually between

• 60 to 110mg%
• Post Prandial (PP) means two hours after the meals, i.e. food, not two hours after 1st Blood samples were collected. This Blood Sugar should be below 140 mg%.

Random Blood Sugar means levels at any time of the day which should be below 160mg% in normal person.

Blood Sugar can be done by Gluconometer. It is an easy process require only drop of blood and results are know at the same time.

Blood Sugar (Self Analysis How Much Under Control)

There are many types of Gluconometer available in the market at present and are easy to use.

We need strips which have pad at one end which reacts with blood and changes its colour which can be read by naked eye or by feeding strip into the Gluconometer which reveals Blood Sugar level.

Method

1. Clean the finger and then press the Autoclix or prick the finger with needle.
2. Massage the finger to bring big drop of blood on yellow pad, i.e. coloured portion of strip.
3. Keep this strip for one minute on a plane surface after drop of blood.
4. Take cotton and clean the blood from the strip in a one process. Don't rub the strip again and again. At this stage you have two options if you have gluconometer then insert the strip (colourd portion) facing you or you wait for one more minute if you don't have gluconometer and after one minute compare the colours with the colours which given on bottle you can read 200mg, 400mg or 500mg% or gluconometer will show the Blood glucose level on meter. If you have other gluconometer then you have to wait for the gluconometer to show 22 seconds and you will hear a beep and then soak the blood, feed the stick into gluconometer and at the end of 50 seconds you can read Blood sugar level.

Blood Sugar Estimation from Laboratory

By giving blood in laboratory you can be the report. Regular Blood Sugar testing is essential to know the result of treatment and one can adjust the does.

Blood Sugar test should be done twice, i.e. in fasting stage and 2 hours after food.

There is doubt in the mind of all diabetics that the blood sugar estimation by gluconometer is not reliable. It is not true, throughout the world these gluconometers are used. Usually there is difference of 10 to 15 mg in the reading of the gluconometer and the readings from outside, i.e. laboratory.

If there is doubt then one can undergo Glucose Tolerance Test.

Glucose Tolerance Test (G.T.T.)

In this test the person is given 75gm of glucose on the day oftest and Blood samples are collected every 30 minutes of 2 hourly and then hourly. Now-a-days many labs don't insist upon taking many samples of blood. Blood glucose more than 2OOmg% one to two hour after glucose ingestion are diagnostic of Diabetes.

Precautions

The person who is undergoing G.T.T., should eat large amount of carbohydrate and should exercise regularly and should not be suffering from any serious disease.

1. Person should not eat anything 8 to 10 hours before test.
2. Person undergoing G.T.T., after giving 1st or Hnd blood sample should not go for walking otherwise it will alter Blood Sugar levels.
3. He should not smoke during this period.

People who should undergo this test

1. Suspected cases of Diabetes.
2. Persons having Family History of Diabetes.
3. Obese person.
4. Persons suffering from tuberculosis or non-healing ulcers.
5. Family History of heart attacks in young age.
6. Persons whose Blood Sugar level rises during stress phases should undergo this test.

Glycosylated Haemoglobin-HbA,1c

Blood test which indicates Blood Sugar levels in a Diabetic patients over a period of last 2-3 months. Specially useful in Diabetes with pregnancy and it helps to give an idea about the efficacy of treatment. If one can afford one should undergo this test atleast once or twice in a year.

Normal levels are expressed in %. Normal levels are less than 6.4%. If it is persistently above 9% it indicates abnormally high Blood Sugar and need proper control.

HbA,c - Normal valure 5.2% - 6.4%

Reduction of HbA,c below 7% reduces incidence of complication. If the HbAIC levels are kept below or around 6.5% there are less chances of complications.

Summary About Tests for Diabetes

• One should regularly get his urine tested for sugar and keep records.
• If there is history of vomiting and loose motions get urine tested for Ketones because timely examination of Ketones in urine can prevent the person going into coma.
• At least once in a year urine should be tested for proteins in urine (even in small amount called microalbumin uria). Appearance of Albumin in urine indicates involvement of kidneys in diabetes and at this stage if Blood Sugar is kept under control further damage to kidney can be prevented.
• Each diabetic patient should have blood sugar test daily if he is on Insulin and once weekly ifhe is on tablets.

Self Monitoring

All Diabetics should learn to monitor their diabetes themselves by doing urine test and Blood glucose estimation. This is called as Home Blood Glucose Monitoring (HBGM). You can make diary and can write about Blood Sugar Levels which will indicate that your Diabetes is under control or not. RB.G.M. is useful in following situations:

1. This is very important for Diabetic patients who are taking Insulin injections. By measuring Blood Sugar they can reduce or increase the Insulin dose and can prevent Hyper or Hypoglycemia.
2. Useful in those patients who are advised strict Diabetic control.
3. In Brittle Diabetics it is useful where Blood Sugar level fluctuates.
4. In Diabetic patients with kidney involvement.
5. Persons using Insulin pumps or 3-4 injections of Insulin daily.
6. It is very useful in patients of Diabetes with pregnancy.

What is Meant by Good Control

1. Normal blood sugar levels.
2. Weight - as near to ideal as possible.
3. Blood pressure should be normal.
4. Blood cholesterol and triglycerides within nbrmallimits.
5. Glycosylated hemoglobin within normal limits.