How the Chalenge test is done.

[ukbill]

OK it seems a few Medical professionals are unable to figure out how the "Challenge" test is supposed to be done and what dosage should be used to get a proper reliable result..

Occasionally very unsafe dosage levels are proposed / used.

In the next posting I will list from the sources I have available how the test should be done and what dosage level should be used.

I will edit it from time to time to update it when I am given new information and on procedure based on the advice of others.

First I will set out what the test is trying to achieve.

The test is to see if after taking in Sucrose or Fructose sugar the patents blood glucose level drops below 3.5 mol this is then considered a positive proof that the patent has the condition called HFI (amongst other names)

Sometimes only one test is done other times both sugars (Fructose and Sucrose) are tested on different days.

Firstly the results from using Sucrose at an absolute maximum dosage rate of .5g per kilo of body weight, with a total maximum safe dosage of 35g.

The results of the blood glucose meter should show an initial increase in the patents blood sugar (as the Glucose is burnt off) followed by a sharp decline in the blood Glucose level as the Fructose remaining the the blood causes the reduction in Blood glucose .

If the test is done using Fructose instead of Sucrose then the absolute maximum dosage of .25g per Kilo body weight should be used. The maximum total safe dosage should not exceed 17.5g

Secondly the base conditions before the test is to take place.

In all cases the test is only done after a 12 hour fast (or slightly less in the case of small children)

No food or nutritious drinks are to be consumed in the 12 hour period prior to the test. Water, black tea and coffee are allowed.

The fasting time is important because without the fast then glucose will be coming into the blood stream from digesting foods and will hold the blood sugar level above 3.5 mol unless dangerous levels of Fructose are given to the patent.

Assumptions.
1/. The patent is basically healthy and showing no signs of liver failure (jaundice etc)
2/. The patent has been weight accurately before the test is started.

Please note the following warning!

"Infusion of 'therapeutic' quantities
of fructose (often 50-200 g) induces irreversible
pathological injury to the liver and kidneys and a
severe metabolic disturbance. Typically the patient
develops signs of shock and acute hepato-renal failure
accompanied by cerebral oedema; death follows
within a few days."

Source of information :-

qjmed.oxfordjournals.org/content/88/4/225.full.pdf+html?ijkey=8c9a6230648e2abaf2131716f735071be230f0ce&keytype2=tf_ipsecsha

I survived 150g pure fructose after 150g sucrose the previous day.. however it took me at least 6 months before I started to recover (if I have recovered completely, how would I know?)

It explains why I am "Brain Dead" most of the time

Joking aside correct Dosage is critical!

I very unhappy that the dosage rate given in the above quoted document is a safe level given that an adult with a body weight of say 100Kg would be dosed with 25g Fructose when they then state that death can occur with a dose as low as 50g (although they do not state body weight of subjects who died to compare.)

I have therefore given a maximum dosage rate of 35g (sucrose) and 17.5g Fructose.

Both of which levels would give me a hard time and a positive Hypoglycaemic response on an empty stomach.

[ukbill]

The test.

Before the test starts a base level blood glucose level should be established by sampling the patients blood, after a 12 hour fast.

After the sugar is administered via IV injection the blood sugar levels should be checked for 2 or 3 hours or until the blood sugar level has returned to normal start of test base level .

The more frequent the blood glucose level is tested the more accurate the result.

Every 20 min should give an accurate result, but not more than every 30 min.

IF the patent proves to be HFI then a meal of HFI safe food shortly after the end of the test will help rebuild the blood sugar level back to more comfortable levels.

The patent should be watched for signs of distress and the usual HFI symptoms..

"The characteristic symptoms of nausea, vomiting, abdominal pain and sweating "

Also signs of Hypoglycaemia such as weakness confusion limpness of limbs etc.

If the patent reacts severely then IV Glucose needs to be given urgently before the patent slips into a coma.

[ukbill]

OK over to you all!

Any suggestions for changes?

I will try to find out more accurate dosage levels I think (hope) my maximum dose levels are OK.

I would far rather a person have to have the test repeated with a higher dose than someone's life irrevocably damaged.

Or they go through the 6 months of hell I went through after my test.