Blood glucose monitoring as a teaching tool for endocrinology: a new perspective

The education of new allied health professionals and nurses in proper endocrine evaluation and care has become critical in recent years, especially considering the greatly increased prevalence of diabetes in adults and children. The evaluation of blood glucose levels in human volunteers over time is a powerful teaching tool for endocrinology that has the added benefit of exposing the student to the most fundamental task in diabetes management. The classic procedure involving the ingestion of sucrose followed by blood glucose monitoring was used here to teach the concepts of nonhormonal control of hormone release and blood glucose homeostasis. In addition, a number of volunteers did not ingest a sucrose solution but merely held it in their mouths and expectorated. This so-called "spit" technique has been successfully used to induce the cephalic phase of insulin release (CPIR), an example of neural control of hormone release. As expected, volunteers who ingested sucrose displayed a 38.5% increase in blood glucose 20 min postingestion and a concomitant decrease in blood glucose to near baseline by 60 min postingestion. Those volunteers who did not ingest the sucrose solution displayed a 12.9% reduction in blood glucose levels by 40 min postcompletion, suggestive of the CPIR, followed by a gradual increase in blood glucose levels to near baseline by 60 min postcompletion. The addition of the "spit" technique to this revised protocol of the evaluation of blood glucose exposes the student to the neural control of hormone release and a second example of energy homeostasis.