Glucose (commonly called "blood sugar") is the primary energy source for the body's cells and the only short-term energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood. Glucose tests measure the level of glucose in your blood or detect glucose in your urine.
A few different protocols may be used to evaluate glucose levels. This article focuses on:
Fasting blood glucose (commonly called fasting blood sugar)—this test measures the level after a fast of at least 8 hours.
Random blood glucose—sometimes your blood glucose will be measured when you have not fasted (randomly).
Other types of glucose tests include:
A glucose tolerance test measures glucose levels after fasting and after you drink liquid containing a specific amount of glucose (see Glucose Tolerance Test).
A specific protocol is used to help diagnose gestational diabetes, which is diabetes that first develops during pregnancy (see Glucose Tests for Gestational Diabetes).
Urine is routinely tested for glucose as part of a urinalysis.
During digestion, the carbohydrates that you eat are broken down into glucose (and other nutrients). They are absorbed by the digestive tract, move into the blood, and circulate throughout the body. Normally, blood glucose rises slightly after a meal and the hormone insulin is released by the pancreas into the blood in response. The amount of insulin released corresponds to the size and content of the meal. Insulin helps transport glucose into the body's cells, where it is used for energy. As glucose moves into the cells and is broken down (metabolized), the blood glucose level drops and the pancreas responds by decreasing the release of insulin.
If this glucose/insulin blood feedback system is working properly, the amount of glucose in the blood remains fairly stable. If the feedback system is disrupted and the glucose level in the blood rises, then the body tries to restore the balance by increasing insulin production.
Diabetes is the most common disease resulting from an imbalance between glucose and insulin.
Type 1 diabetes results when the body is not able to produce sufficient insulin to control blood glucose levels. Usually in type 1 diabetes, the cells that produce insulin (beta cells) have been destroyed by the person's own immune system.
Type 2 diabetes results from a combination of insulin resistance (the body does not react normally to insulin) and a relative decline in insulin production.
Some women may develop gestational diabetes, which is high blood glucose that develops during pregnancy. (For more information, see the article on Glucose Tests for Gestational Diabetes.)
Severe, acute changes in blood glucose, either high (hyperglycemia) or low (hypoglycemia), can be life-threatening, causing organ failure, brain damage, coma, and, in some cases, death. Chronically high blood glucose levels that can occur with untreated or poorly controlled diabetes can cause progressive damage to body organs such as the kidneys, eyes, heart and blood vessels, and nerves. Chronic hypoglycemia can lead to brain and nerve damage.
HbA1c Blood Test:
If you have diabetes, your HbA1c level may be done every 2-6 months by your doctor or nurse. This test measures your recent average blood sugar (glucose) level. Because it is an average measurement you do NOT need to fast on the day of the test. The test measures a part of the red blood cells. Glucose in the blood attaches to part of the red blood cells. This part can be measured and gives a good indication of your average blood glucose over the previous 2-3 months.
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