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Control of Blood Glucose Levels Abnormal blood glucose level is an inherited condition caused by a defect or defects in the gene that codes for the enzyme, glucose- 6 -phosphate dehydrogenase (G 6 PD). It can cause hemolytic anemia, varying in severity from life-long anemia, to rare bouts of anemia to total unawareness of the condition. The episodes of hemolytic anemia are usually triggered by oxidants, infection, or by eating fava beans. Abnormal blood glucose level is the most common enzyme deficiency in the world, with about 400 million people living with it. It is most prevalent in people of African, Mediterranean, and Asian ancestry. The incidence in different populations varies from zero in South American Indians to less than 0. 1 % of Northern Europeans to about 50 % of Kurdish males.
In the United States, it is most common among African American males; about 11 to 14 % are deficient. The most significant consequence of this disorder is hemolytic anemia, which is usually episodic, but the vast majority of people with this deficiency have no symptoms. The many different forms of abnormal blood glucose level have been divided into five classes according to severity. The major symptoms of hemolytic anemia are jaundice, dark urine, abdominal pain, back pain, lowered red blood cell count, and elevated bilirubin. People who suffer from severe and chronic forms of this deficiency in addition may have gallstones, enlarged spleens, defective white blood cells, and cataracts.
Attacks of hemolytic anemia are serious for infants. Brain damage and death are possible but preventable outcomes. Newborns with deficient blood glucose level are about 1. 5 times as likely to get neonatal jaundice than newborns without this deficiency. In a typical attack of hemolytic anemia, no treatment is needed; the patient will recover in about eight days.
However, blood transfusions are necessary in severe cases. Recent success treating elevated bilirubin in newborns by exposing them to bright light has decreased the need for neonatal transfusions. Vitamin E and folic acid (both anti-oxidants) may help decrease hemolysis in deficient individuals. The prognosis for almost everyone with this deficiency is excellent. Large studies have shown that individuals with deficient blood glucose level do not acquire any illnesses more frequently than the rest of the population.
In fact, the opposite may be true for some diseases like ischemic heart disease and cerebrovascular disease. Most episodes of hemolytic anemia can be prevented by avoiding fava beans, oxidant drugs, and oxidant chemicals. All of the following oxidants can trigger attacks: acetanilide, dawson, doxorubicin, furazolidone, methylene blue, nalidixic acid, naphthalene, niridazole, nitrofurantoin, phenazopyridine, phenyl hydrazine, prima quine, quinidine, quinine, sulfacetamide, sulfamethoxazole, sulfonamide, sulfapyridine, thiazolesulfone, toluidine blue, and trinitrotoluene. Since infections also trigger hemolytic attacks and have other dire consequences, sometimes it is advisable to use one of the listed drugs.
It is especially important to screen newborns who are likely to have this deficiency to ensure that deficient babies won't be subjected to any of the triggers of hemolytic anemia. Pregnant women, especially in areas where blood glucose level deficiency is prevalent, should avoid eating fava beans. Patients with diabetes mellitus are advised to self-monitor their blood glucose levels; however, checking blood glucose daily is costly, and no evidence supports this practice in patients with type 2 diabetes. The American Diabetes Association says, Optimal frequency of self-monitoring of blood glucose for patients with type 2 diabetes is not known, but should be sufficient to facilitate reaching glucose goals. Karter and associates conducted a cohort study to determine the effectiveness of self-monitored blood glucose levels in improving glycemic control, even in patients with type 2 diabetes. The professionals conclude that following recommendations for glucose monitoring is associated with better control of diabetes.
Since this was a cohort study, causality cannot be determined, but the study provides some support for recommending self-monitoring of blood glucose levels in patients with type 1 and type 2 diabetes. One of the main goals of the management of type 1 diabetes in the pediatric population is to avoid extremes of glycemic excursion. By treating blood glucose levels that are outside of a predetermined age-specific target range with supplemental oral glucose or extra insulin, children and teenagers can minimize the episodes of both hypoglycemia and hyperglycemia that can impair judgment and learning and lead to coma, convulsions, recurrent keto acidosis, and the long-term micro circulatory and neuropathic complications of this disease. However, while it is not very difficult to instruct patients and families in how to correct hypoglycemia with oral glucose, it is challenging to teach insulin dosage adjustment algorithms designed to normalize elevated blood glucose levels and to compensate for alternations in carbohydrate intake.
Even with instruction, many families feel uneasy adjusting insulin dosages on their own because of the complexities of these adjustment algorithms, and they often pers ist in believing that they must have prior contact with a health care provider to ensure accuracy. The Insulin Dosage Guide was developed as an alternative to the previously used written-on-paper algorithms. It was designed for correction of abnormal blood glucose levels, not for alteration of the base dose of insulin. Based on the Diabetes Control and Complications Trial and the American Diabetes Association Standards of Care, as well as the "Staged Diabetes Management" of Etzwiler, members of this association had used insulin correction algorithms in our center to not only improve gloated hemoglobin levels, but to allow patients more flexibility in their day-to-day diabetes management. However, they found that these paper algorithms, composed of multiple columns listing the blood glucose ranges, the number of units that the insulin dosage was to be increased or decreased, and the time to wait between the injection and the meal, were not easy for patients to use.
In addition, it took the team members a lengthy time period for patient and family instruction and to ensure that subjects could accurately determine the correction insulin dosage by referring to their sheet of paper. Therefore, the development of a more user-friendly format for insulin adjustment algorithms to correct blood glucose levels outside of the target range appeared to be critical if the associations members were to successfully promote patient advancement in diabetes management. Words: 1010 Bibliography: Karter AJ, et al. Self-monitoring of blood glucose levels and glycemic control: the Northern California Kaiser Permanente Diabetes Registry.
Am J Med July 2001; 111: 1 - 9. UK Prospective Diabetes Study (UKPDS) Group: Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352: 854 - 865, 1998 Willey KA, Molyneaux LM, Yue DK: Obese patients with type 2 diabetes poorly controlled by insulin and metformin: effects of adjunctive dexfenlluramine therapy on glycemic control. Diet Med 11: 701 - 704, 1994 Kelley DE: Effects of weight loss on glucose homeostasis in NIDDM.
Diabetes Rev 3: 366 - 377, 1995 Klein R: Hyperglycemia and microvascular and macro vascular disease in diabetes (Review). Diabetes Care 18: 258 - 268, 1995 Gallic han M. Self monitoring of blood glucose by people with diabetes: evidence based practice. BMJ 1997; 314: 964 - 6.
Gill GV, Huddle KR. Assessment of glycemic control in the diabetic clinic. Pract Diabetes 1989; 6: 77 - 9. Worth R, Home PD, Johnston DG, Anderson J, Ashworth L, Brain JM, et al. Intensive attention improves glycemic control in insulin-dependent diabetes without further advantage from home blood glucose monitoring. BMJ 1982; 285: 1233 - 40.
Harris MI, Cowie CC, Howie LJ. Self-monitoring of blood glucose by adults with diabetes in the United States population. Diabetes Care 1993; 16: 1116 - 23.
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Research essay sample on Control Of Blood Glucose Levels
