CC1 POST LAB MID

PRIMARY STANDARD REAGENT

• This refers to a highly pure compound that is used in chemical analysis to determine the concentration of another substance.

• reagents are carefully prepared and have a known high level of purity.

• They are typically used in titrations to Standardize solutions, particularly in acid-base and redox reactions.

• reagents are substances that are standardized against primary standards.They are generally used when a primary standard is too costly, too unstable, or not available in sufficient purity.

• not as pure as primary standards, but their purity is known and

consistent.

• They are used in routine laboratory analyses where absolute accuracy is not crucial.

Secondary standard

• material that is used to validate measurements or to calibrate analytical instruments. They are produced and certified by national and international standards

• organizations like NIST (National Institute of Standards and Technology) in the United States.

• These materials have well-defined properties,such as composition, purity, and stability, and are accompanied by a certificate detailing these properties and their uncertainties.

• They are indispensable tools in quality control, method validation, and ensuring the accuracy of measurements in

  various fields, including chemistry,environmental science, and materidig science.

STANDARD REFERENCE MATERIALS

NIST

(National Institute of Standards and Technology)

: Standards serve as _________ points for the analytical instrument. By analyzing known concentrations of a substance, the instrument can be _________ to accurately measure concentrations in the samples being tested. This ensures that the instrument is functioning properly and provides accurate readings.

Calibration

: Including standards allows for ongoing _________ throughout the analytical run. By analyzing standards at regular intervals, deviations from expected values can bedetected, indicating potential issues with the analysis process or instrument performance. This helps to identify and correct any problems early on, ensuring the reliability of the results.

Quality Control

: Standards are used to _________. being employed in the analysis. By comparing the result obtained from standards with expected values, the accuracy and precision of the analytical method can be confirmed. This is particularly important when developing new analytical methods or when using methods in new laboratory settings.

Validation of Methodology

: Standards provide a basis for normalizing the results obtained from different analytical runs or instruments. By including standards with known coneentrations in each run, results can be compared across runs ór instruments allowing for consistency and standardization of measurements.

Normalization of Results

: Standards are used to assess the overall performance of the analytical system. By analyzing standards with known concentrations, parameters such as accuracy, precision, and sensitivity can be evaluated. This information is essential for ensuring that the analytical system meets the required standards for reliability and validity.

Assessment of Analytical Performance

: It allows for the _________ determination of the concentration of an analyte in unknown samples by comparing their measured responses to the calibration curve. This is particularly useful in techniques like chromatography and spectroscopy, where the intensity of a signal is proportional to the concentration of the analyte.

Quantitative Analysis

Calibration: The ________ serves as a reference for calibyatig the instrument. By establishing a relationship between fhe instrument's response and known concentrations, the instrument can be calibrated to accurately méasure concentrations in unknown samples.

curve

Quality Control: The calibration curve provides a ______ for ongoing quality control during analytical runs. By analyzing standard samples periodically throughout the analysis, deviations from the calibration curve can be detected, indicating potential issues with instrument performance or analysis conditions.

means

: The shape and linearity of the calibration curve can also provide information about the analytical method's performance, including its dynamic range and linearity.This allows for the verification of the method's suitability for the intended application.

Verification of Linearity and Range

: In some cases,regulatory authorities require the use of reference calibration curves as part of ________ procedures to ensure the accuracy precision, and reliability of the analytical method.

Method Validation

: refers to how feasible and convenient it is to perform the analytical method in a real-world setting.Factors such as the availability of equipment, ease of sample preparation, time required for analysis, and costeffectiveness are considered when assessing practicality. A practical method should be efficient, economical, and suitable for routine use.

Practicality

: refers to the consistency and reproducibility of results obtained from the analytical method. A reliable method produces accurate and consistent results when performed multiple times under similar conditions. It should be free from random errors and provide reliable data for decision-making purposes.

Reliability

: defines the concentration range over which the analytical method can provide accurate and precise measurements.It spans from the lowest to the highest concentration levels that the method can reliably quantify. It is important for the method to cover the range of analyte concentrations typically encountered in the samples being analyzed.

Analytical Range

: refers to the ability of the method to detect small changes in analyte concentration. It is typically expressed as the smallest detectable change in concentration that can be reliably measured by the method. A highly sensitive methód can detect low concentrations of analytes, making it suitable for applications where trace levels of substances need to be quantified.

Analytical Sensitivity

: is the lowest concentration of an analyte that can be reliably detected but not necessarily quantified by the analytical method. It is determined experimentally and represents the lowest concentration at which the signal-to-noise ratio is sufficiently high to distinguish the analyte from background noise.

Detection Limit

limit of detection (LOD) also known as

DETECTION LIMIT

: refer to measurements obtained from sample that do not contain the analyte of interest. They are used to/asséss and correct for background noise or interference in the analyfical method.

It help ensure the accuracy and reliability of the measurements by providing a baseline reference for comparison with samples containing the analyte.

Blank Readings

: refers to the ability of the method to accurately measure the target analyte in the presence of other substances or interferences.

It ensures that the method selectively responds to the analyte of interest without being influenced by matrix effects or interfering substances present in the sample.

Analytical Specificity

: occurs when other substances present in the samplg interfere with the accurate measurement of the target analyte _____ can lead to inaccuracies and affect the reliabiity/of the analytical method. Strategies such as sample preparafior techniques, use of selective reagents, or adjustment of instrumental parameters may be employed to mitigate interference effects.

Interference

: assesses the accuracy of the analytical method by measuring the ability of the method to recover known amounts of the analyte added to a sample.

It is expressed as the percentage of the analyte recovered compared to the expected value.

studies are essential for validating the accuracy of the method and assessing any systematic errors or biases.

Recovery

: refers to the repeatability or reproducibility of results obtained from the analytical method. It measures the degred/of scatter or variation in repeated measurements of the same sample under identical conditions.

It can an be expressed as the standard deviation, coefficient of variation, or confídence interval of the measurements.

A precise method produces consistent results with low variability, indicating high ________.

Precision

reference material or substance with known characteristics used to assess the accuracy and precision of analytical methods or instruments in laboratory settings. In clinical chemistry work, ___________ ______ _______playy a crucial role in ensuring the reliability ánd validity of test results obtained from patient sample

Quality Control Material (QCM)

: Quality control materials with known concentrations of analytes are analyzed alongside patient samples to verify that the analytical method accurately from the expected value in the quality control material alerts measures the concentration of the target analyte. Any deviation laboratory staff to potential inaccuracies in the test results and prompts corrective action.

Assessing Accuracy

: By analyzing quality control materials reproducibility of the analytical method. Consistent resuli/method produces reliable and reproducible measurements, repeatedly over time, iaboratory staff can assess the precisier/or obtained from the quality control material indicate thatthe ensuring confidence in the test results generated for patient samples

Evaluating Precision

Monitoring Performance: ______ _______ of quality control materials helps monitor the performance of analyfical instruments and detect any trends or shifts in accuracy or precision. Deviations from established control limits may indicate instrumentmalfunction, reagent issues, or other factors affecting test performance, prompting investigation and corrective action to maintain the quality of results.

Regular analysis

: When implementing new analytigal methods or instruments, quality control materials are used to /ejfy the performance and accuracy of the method before anelyzing patient samples. Comparison of results obtained from quality control materials using the new method against established reference values helps validate the method's suitability for clinical use.

Verification of New Methods

Meeting Regulatory Requirements: _____________ _____often require clinical laboratories to participate in external quality assessment schemes and demonstrate proficiency in testing by analyzing quality control materials. Compliance with regulatory standards ensures that laborglory testing meets established quality standárds and provides reliable and accurate results for patient care.

Regulatory bodies

> ADVANTAGES OF COMMERCIALLY-PREPARED CONTROL MATERIAL:

: Commercial control materials are often ____________ and traceable to reference materials, ensuring consistency and comparability across different laboratories.·

: They _________to use as they are readily available, require minimal preparation, and come with documentation such as certificates of analysis.

: Manufacturers employ stringently quality control measures, ensuring the accuracy, stability, and reliability of the control material.

Standardization

Convenience

Quality Assurance

ADVANTAGES OF IN-HOUSE QUALITY CONTROL MATERIAL:

•: In-house control materials can be ________ to suit the specific needs of the laboratory,allowing for flexibility in analyte concentration, matrix,and stability.

• : In-house preparation may be more ________ __________ for laboratories with limited budgets. gsy eliminates the need to purchase commercial contfol materials.

• : Laboratories can quickly respond to changes in test requirements or analyte concentrations by preparing in-house control materials as needed

Customization

Cost-effectiveness

Rapid Response

> DISADVANTAGES OF COMMERCIALLY-PREPARED CONTROL MATERIAL:

• : Commercial control materials can be expensive,particularly for laboratories with high testing volumes or a wide range of analytes.

: While commercially-prepared control materials typically have a longer shelf-life, they may sil have expiration dates, and improper storage can gtffgct their stability.

: Commercial control matérials may not precisely match the characteristics óf patient samples or specific test methodologies used in the laboratory.

Cost

Shelf-life

Limited customization

> DISADVANTAGES OF IN-HOUSE QUALITY CONTROL MATERIAL:

• : Preparation of in-house control materials requires time, resources, and expertise from laboratory staff,which can be .

: Laboratories must validate in-house control materials to ensure accuracy, stability, and reproducibility which requires additional time and effort.

: In-house control materials may exhibit greater variability compared to commercial materials due to variations in preparation methods, matrix effects, and stability over time.

Labor-intensive

Validation

Variability

a systematic approach to quality management and improvement that aims to reduce defects and errors in processes. It originated in manufacturing but has since been adopted across various industries, including healthcare, finance, and service sectors.

The goal of this is to achieve nearperfect performance by reducing defects to a level of no more than 3.4 defects per million opportunities (or achieving a sigma level of 6.0), hence the name "." By following this structured approach, organizations gon improve customer satisfaction, increase efficiency, and drive continuous improvement.

SIX SIGMA SYSTEM

is a methodology focused on eliminating waste and improving efficiency in processes.

Originally developed in manufacturing, principles have been widely adopted across various industries, including healthcare, services and software development.

The primary goal of this is to deliver maximum value to customérs with minimal waste

Empowering employees at all levels to contribute to process improvement.

LEAN SYSTEM

Identifying and eliminating eight types of waste:?

(TIMWOOD-)

Transportation,Inventory, Motion, Waiting,Overproduction, Over-processing, Defects, and Unused Employee Talent .

(JIT)

Just-in-Time

(VSM)

Value Stream Mapping

: This technique measures the intensity of light emitted by excited atoms in a flame. It relies on the principle that atoms of different elements emit characteristic wavelengths of light when they return to their ground state from an excited state in a flame.

Flame emission spectrophotometry

: This technique measures the absorption of light by the ground-state atoms in the gaseous phase. It utilizes the principle that atoms absorb light at specific wavelengths when they transition from the ground state to highgr energy levels.

Atomic absorption spectrophotometry

: This technique measures the intensity of fluorescence emitted by a sample when it is excited by light of a specific wavelength. It relies on the principle that certain molecules, called fluorophores, absorb light at one wavelength and emit light at a longer wavelength.

Fluorescent spectrophotometry

is the measurement of optical density or absorbance of light by a sample. It is often used in chromatography to quantify the concentration of analytes separated on a chromatographic column based on the absorbance of light passing through the sample.

Densitometry

separates ions based on their charge properties. It relies on the principle of electrostatic interactions between charged ions in the sample and oppositely charged groups on a solid sfationary phase.

lon exchange chromatography

separates volatile compounds based on their distribution between a stationary liquid phase and a mobile gas phase. It rélies on the principle of differential partitioning of analytes between the two phases.

Gas-liquid chromatography

is an electrochemical technique that measures the current flowing through a cell containing a solution with a varying voltage. It is based on the principle that certain substances undergo reduction or oxidation at a working electrode, leading to changes in current.

Polarography

measures the current flowing between two electrodes in response to an applied potential. It is commonly used in electroanalytical chemistry to detect and quantify analytes based on their electrochemical activity.

Amperometry

is an electroanalytical technique/thdf measures the quantity of charge passed during an electrochemical reaction. It is often used for quantitative analysis and determination of the concentration of substances in a sample.

Coulometry

measures the electrical conductivity of a solution. It relies on the principle that the conductivity of a solution is directly proportional to the concentration of ions present.

Conductometry

measures the osmotic pressure of solution. It is based on the principle that the concentration of solute particles in a solution affects the movement of,solvent across a semipermeable membrane.

Osmometry

measures the reduction in fight intensity as it passes through a turbid sample. It is used to quantify the concentration of suspended particlés or solutes in a solution based on their light-scattering properties.

Turbidimetry

measures the intensity of light scattered by particles in a solution at right angles to the incident light. It is used to quantify the concentration of suspended particles or macromolecules in a sample based on their scattering properties.

Nephelometry

involves thé use of antibodies and antigen-antibody interactions for analytical purposes. It is used to detect and quantify specific analytes in a sample by exploiting the selectivity and specificity of immune reactions.

Immunochemistry

occur when the absorption spectrum of the analyte overlaps with the absorption spectrum of other species present in the sample. This overlap can lead to errors in quantification by interfering with the/measurement of the analyte's absorption signal.

Spectral interferences

SPECTRAL INTERFERENCES IN AAS

: occur when the absorption lines of different elements or chemical species coincide or are very close to each other. This can result in the interference of one element's signal with that of another, leading to inaccurate quantification.

: occurs when broad absorption bands from molecular species in the sample overlap with the absorption lines of the analyte. This can obscure or reduce the intensity of the analyte's absorption signal, affecting the accuracy of measurement.

: refers to non-specific absorption of light by components in ihe sample matrix or instrumental components such as windows, lamps, or mirrors can contribute to baseline drift or noise, making it challenging to distinguish the analyte's absorption signal from background noise.

Line Overlaps

Continuum Absorption

Background Absorption

occur due to chemical reactions between the analyte and other species present in the sample, leading to the formation of compounds that alter the analyté's absorption characteristics.

Chemical interferences

: occur when the analyte or interfering species form ions in the flame or vapor phase, affecting the atomization efficiency or absorption characteristics of the analyte. This can result in changes in the intensity or shape of the absorption signal, leading to inaccuracies in quantification.

lonization Interferences

: occur between the analyte and other components in the sample matrix can lead to the formation of compounds that absorb light at the same wavelength as the analyte or alter its absorption properties. This can result in shifts in the absorption peak or changes in the baseline, complicating the measurement of the analyte.

Chemical Reactions

: occur when components in the sample matrix influence the atomization efficiency, vaporization, or transport of the analyte to the light path in the AAS instrument.

can lead to signal suppression or enhancement, affecting the accuracy and precision of the analytical results.

Matrix Effects

___________ of a spectrophotometer is essential for ensuring accurate and reliable performance in measuring absorbance and wavelength accuracy It involves several steps to evaluate and adjust different parameters, including wavelength accuracy, absorbance linearity, and stray light.

Calibration

To calibrate it , a calibrated _______ standard is typically used. This standard consists of solutions with known absorbance peaks at specific wavelengths.

Start by setting the spectrophotometer to the desired wavelength using the wavelength standard.

Measure the absorbance of the standard solution at the specified wavelength and record the observed absorbange value.

Compare the observed absorbance with the expected absorbance at that wavelength.

Any deviation indicátes a wavelength error.

Adjust the spectrophotometer's wavelength settings until the observed absorbance matches the expected absorbance at the specified wavelength.

Wavelength Accuracy

Calibration of ________ involves verifying the accuracy of the instrument's response to different concentrations of a standard _______ solution.

Prepare a series of standard solutions with known concentrations covering the expected range of absorbance.

Measure the absorbance of each standard solution using the spectrophotometer and record the readings.

Plot a calibration curve with absorbance on the y-axis and concentration on the x-axis.

Verify the linearity of the calibration curve by ensuring that the data points fall along a straight line. Any deviation may indicate non-linearity in the instrument's response.

Adjust the instrument's settings or recalibrate if necessary to achieve linearity over the specified range of absorbance values.

Absorbance

______calibration ensures that the spectrophotometer's response is proportional to the concentration of the absorbing species over a specified range.

Measure the absorbance of standard solutions with varying concentrations to cover the intended range.

Plot a calibration curve as described in the absorbance calibration process.

Perform regression analysis to determine the linearity of calibration curve. The correlation coefficient (R2) should be close to 1, indicating a high degree of linearity.

If the correlation coefficient is not within an acceptable range, adjust the instrument's settings or recalibrate as needed to improve linearity.

Linearity

The calibration evaluates the presence of unwanted light that inferferes with absorbance measurements at low absorbance values.

Measure the absorbance of a blank solution (solvent only) with negligible absorbance at the desired wavelength.

Gradually dilute the blank solution to obtain lower absorbance values.

Plot the absorbance readings against the concentration or dilution factor.

Extrapolate the absorbance to zero concentration or infidite dilution.

Any non-zero intercept indicates the presence of stray light.

Adjust the instrument's settings or perform corrective actions to minimize stray light effects, such as cleaning optical components or using correction factors.

Stray light

is a technique used to separate charged molecules, such as DNA,RNA, or proteins, based on their size and charge. The principle of electrophoresis relies on the movement of charged molecules and electric field.

It involves the migration of charged molecules in a gel matrix under the influence of an electric field.

Electrophoresis

is a polysaccharide derived from seaweed, often used for separating large nucleic acids such as DNA fragments.

It forms a gel matrix when cooled, providing a poroys structure through which molecules can migrate.

_____ ___ ________ is widely used in molecular biology and genetics for DNA analysis including DNA fragment size determination and DNA purification.

AGAROSE GEL

Agarose gel electrophoresis

is a synthetic polymer used for separating proteins, nucleic acids, and other biomolecules based on size,charge, and shape.

It offers higher resolution compared to agarose gel and is commonly used for protein separation techniques like SDS PAGE (Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis) and native PAGE (Polyacrylamide Gel Electrophoresis).

It can be prepared with varying concentrations to achieve different separation ranges and

resolutions.

POLYACRYLAMIDE GEL (PAGE)

SDS PAGE

(Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis)

is a thin, porous material commonly used for electrophoretic separation of proteins, lipids, and enzymes. It provides a support medium for proteins to migrate through, based on differences in charge and size

______ ______ ___________ is often used in clinical laboratories for serum protein analysis and diagnosis of protein disorders.

Cellulose acetate membrane

Cellulose acetate electrophoresis

is derived from starch granules and is used primarily for separating proteins and enzymes based on charge and size differences.

It offers a gentle separation environment and is suitable for analyzing heat-labile proteins and enzymes.

______ ___ __________ is commonly used in biochemical and clinical research for anályzing protein isoforms and enzyme variants.

Starch gel

Starch gel electrophoresis

Etiology: occurs in individuals with cystic fibrosis(CF), a genetic disorder that primarily affects the respiratory and digestive systems.

Pathogenesis: CF-related pancreatic damage leggs to impaired insulin secretion and diabetes.

Clinical Characteristics: shares features with both type 1 and type 2 diabetes but has unique clinical considerations due to the underiying CF condition.

CYSTIC FIBROSIS-RELATED DIABETES (CFRD)

(CFRD)

CYSTIC FIBROSIS-RELATED DIABETES

Diabetes: it is > 126 mg/dL (7.0 mmol/L) after an overnight fast (no caloric intake for at least 8 hours).

Impaired Fasting Glucose (IFG): it's level between 100 and 125 mg/dL (5.6 to 6.9 mmol/L) indicate IFG, also known as prediabetes.

FASTING PLASMA GLUCOSE TEST(FPG)

(FPG)

FASTING PLASMA GLUCOSE TEST

▼ Diabetes: 2-hour plasma glucose 2 200 mg/dl (11.1 mmol/L) during an this using a glucose load of 75 g.

Impaired Glucose Tolerance (IGT): 2-hour plasma glucose levels between 140 and 199 mg/dL (7.8 to 11.0 mmol/L) indicate IGT, also known as prediabetes.

ORAL GLUCOSE TOLERANCE TEST (OGTT)

Diabetes: HbAlc > 6.5% (48 mmol/mol).HbAlc reflects average blood glucose levels over the past 2-3 months.

Normal: HbAlc < 5.7% (39 mmol/moi).

Prediabetes: HbAlc levels between 5.7%and 6.4% (39 to 47 mmol/mol).

GLYCOSYLATED HEMOGLOBIN TEST(HbA1c)

are essential tools for monitoring blood sugar levels, especially for individuals with diabetes. These are designed to be used with a glucose meter,which measures the concentration of glucose in a small drop of blood. :

Blood glucose test strips

: Blood glucose test strips contain specific chemicals that react with glucose in the blood to produce a measurable signal. The most common reaction involves the enzyme glucose oxidase, which catalyzes the oxidation of glucose to produce gluconic acid and hydrogen peroxide. The amount of hydrogen peroxide generated is directly proportiong to the glucose concentration in the blood.

Chemical Composition

: This is the area on the test strip where the blood sample is applied. It is usually made of an absorbent material that draws in the blood drop to ensure complete coverage of the reaction area.

It helps to control the volume of blood applied to the strip and facilitates the interaction with the reagents.

Substrate Pad

: Blood glucose test strips contain various reagents, including the enzyme glucose oxidase, mediators, stabilizers, and colorchanging agents. These reagents work together to facilitate the oxidation reaction of glucose and produce a detectable signal, typically a change in color or electrical current.

Chemical Reagents

: This is where the chemical reaction between glucose and the reagents takes place is usually located downstream from the substrate pad and may contain electrodes or other sensing elements for detecting the reaction products.

Reaction Area

: Some test strips include this that detect the electrical current generated during the oxidation reaction. This current is proportional to the glucose concentration in the blood and is used to quantify the glucose level.

Electrodes

where the glucose meter reads the signal produced by the reaction on the test strip. It may consist of optical sensors, electrodes, or other detection mechánisms depending on the design of the meter.

measurement window

: Each test strip package includes an _______ ____ and ___ _______ for quality control purposes. It is essential to check these details before using the strips to ensure accuracy and reliability of the results.

Expiration Date and Lot Number

: Blood glucose test strips are typically packaged in individual foil or plastic pouches to protect them from moisture and contamination. Some packages include desiccants to absorb moisture and maintain the stability of the strips.

Packaging

: Both diabetes and hypertension share common risk factors such as obesity, physical inactivity, unhealthy diet (hígh in salt and processed foods), and genetics,

Individuals with one condition are more likely to Develop the other due to these shared risk factors.

Shared Risk Factors

a hallmark of type 2 diabetes, is associated with hypertension

It leads to increased levels of this in the blood,which can cause blood vessels to constrict and raise blood pressure.

Insulin Resistance

: Diabetes and hypertension that contribute to this, which is the impairment of the inner lining of blood vessels.

it leads to decreased vasodilation and increased vascular inflammation, promóting hypertension.

Endothelial Dysfunction

: Both Diabetes mellitus and hypertension (high blood pressure) are often co-existing conditions, and their association is well-established.

Here's how they are related:

conditions can cause damage to the kidneys. Diabetes is a leading cause of kidney disease (diabetic nephropathy, while,hypertension can also lead to kidney damage (hypertensive nephropathy). The coexistence of both conditions can accelerate the progression of kidney disease.

Renal Damage

: Diabetes and hypertensigh.independently increase the risk of this such as heart attacks, stroke, and peripheral artery disease. When both conditions are present, the risk of cardiovascular complications is further amplified, leading to poorer outcomes.

Cardiovascular Complications

: they exacerbate each other's negative impact on overall health. Poorly controlled diabetes can worsen hypertension, and vice versa, leading to a vicious cycle of complications.

Synergistic Effect

Management Challenges: Treating one condition can somethings exacerbate the other. For example, certain ________ _____________ can worsen blood glucose control in diabetes, Wwhile some diabetes medications may increase blood pressúre.This makes management more challenging and requires a tailored approach for each individual.

antihypertensie medications

is a life-threatening complication of diabetes mellitus, typically occurring in individuals with type I diabetes but can also occur in those with type 2 diabetes,especially under certain conditions such as severé illness or infection.

The pathogenesis of this involves a complex interplay of metabolic disturbances, primarily driven by insulin deficiency and the resulting dysregulation of glucose and lipid metabolism.

Diabetic Ketoacidosis (DKA)

Insulin Deficiency: DKA usually develops in the setting of profound insulin deficiency, either due to insufficient insulin production (as seen in type I diabetes) or inadequate insulin action (as seen in advanced type 2 diabetes). Insulin is essential for facilitating glucose uptake by cells and suppressing the release of glucose from the liver. In absence, glucose cannot enter cells to serve as an energy source, leading to ______________.

hyperglycemia

Hyperglycemia: The hallmark feature of DKA is severe hyperglycemia, with blood glucose levels typically exceeding ______mg/dl. In the absence of sufficient insyln y6 promote cellular glucose uptake, glucose accumulates in the bloodstream, leading to hyperglycemia. This high blood glucose concentration drives osmotic diuresis, resulting in the loss of water and electrolytes, such as sodium, potassium, and chloride, through the kidneys.

250 mg/dL (13.9 mmol/L)

: The loss of water and electrolytes through osmotic diuresis exacerbates the electrolyte imbalance seen in DKA.

Potassium,in particular, is depleted due to increased urinary excretion and intracellular shift secondary to insulin deficiency and acidosis. Despite total body potassium depletion, serum potassium levels may initially appear normal or elevated due to extracellular shifts. However, as insulin therapy is initiated, potassium shifts back into cells, Leading to hypokalemia, which can result in life-threatening cardiac arrhythmias.

Electrolyte Imbalance

, also known as Hemoglobin Alc (HbAlc), is a form of hemoglobin that becomes glycated when glucose molecules in the blood bind to hemoglobin molecules. This process occurs over the lifespan of red blood cells (approximately 120 days) and is directly proportional to the average blood glucose concentration of that time period. As a result, measuring the percentage of HbAlc in the blood provides án indication of the average blood glucose lével over the preceding two to three months.

Glycosylated hemoglobin

: High-performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC-MS) are widely used techniques for HbAlc determination.

In HPLC, the sample is passed through a chromatographic column, where HbAlc is separated from hemoglobin fractions based on differences in their chemical properties. LC-MS combines liquid chromatography with mass spectrometry for accurate quantification of HbAIC.

Chromatography Methods

(LC-MS)

liquid chromatography-mass spectrometry