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Lab Tests For Diabetes Patients

Test Id: Hba1c Hemoglobin A1c, Blood

Test Id: Hba1c Hemoglobin A1c, Blood

Evaluating the long-term control of blood glucose concentrations in diabetic patients Diagnosing diabetes Identifying patients at increased risk for diabetes (prediabetes) Diabetes mellitus is a chronic disorder associated with disturbances in carbohydrate, fat, and protein metabolism characterized by hyperglycemia. It is one of the most prevalent diseases, affecting approximately 24 million individuals in the United States. Long-term treatment of the disease emphasizes control of blood glucose levels to prevent the acute complications of ketosis and hyperglycemia. In addition, long-term complications such as retinopathy, neuropathy, nephropathy, and cardiovascular disease can be minimized if blood glucose levels are effectively controlled. Hemoglobin A1c (HbA1c) is a result of the nonenzymatic attachment of a hexose molecule to the N-terminal amino acid of the hemoglobin molecule. The attachment of the hexose molecule occurs continually over the entire life span of the erythrocyte and is dependent on blood glucose concentration and the duration of exposure of the erythrocyte to blood glucose. Therefore, the HbA1c level reflects the mean glucose concentration over the previous period (approximately 8-12 weeks, depending on the individual) and provides a much better indication of long-term glycemic control than blood and urinary glucose determinations. Diabetic patients with very high blood concentrations of glucose have from 2 to 3 times more HbA1c than normal individuals. Diagnosis of diabetes includes 1 of the following: -Fasting plasma glucose > or =126 mg/dL -Symptoms of hyperglycemia and random plasma glucose >or =200 mg/dL -Two-hour glucose > or =200 mg/dL during oral glucose tolerance test unless there is unequivocal hyperglycemia, confirmatory testing should be Continue reading >>

Diagnosis

Diagnosis

Print Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be evident, the American Diabetes Association (ADA) has recommended screening guidelines. The ADA recommends that the following people be screened for diabetes: Anyone with a body mass index higher than 25, regardless of age, who has additional risk factors, such as high blood pressure, a sedentary lifestyle, a history of polycystic ovary syndrome, having delivered a baby who weighed more than 9 pounds, a history of diabetes in pregnancy, high cholesterol levels, a history of heart disease, and having a close relative with diabetes. Anyone older than age 45 is advised to receive an initial blood sugar screening, and then, if the results are normal, to be screened every three years thereafter. Tests for type 1 and type 2 diabetes and prediabetes Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal. If the A1C test results aren't consistent, the test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — your doctor may use the following tests to diagnose diabetes: Random blood sugar Continue reading >>

Role Of Laboratory Tests In Diabetes Mellitus Featured

Role Of Laboratory Tests In Diabetes Mellitus Featured

Diagnosis of DM Screening of DM Assessment of glycemic control Assessment of associated long-term risks Management of acute metabolic complications. LABORATORY TESTS FOR DIAGNOSIS OF DIABETES MELLITUS Chemical methods: – Orthotoluidine method – Blood glucose reduction methods using neocuproine, ferricyanide, or copper. Enzymatic methods: These are specific for glucose. – Glucose oxidase-peroxidase – Hexokinase – Glucose dehydrogenase Fasting blood glucose: Sample for blood glucose is withdrawn after an overnight fast (no caloric intake for at least 8 hours). Post meal or postprandial blood glucose: Blood sample for glucose estimation is collected 2 hours after the subject has taken a normal meal. Random blood glucose: Blood sample is collected at any time of the day, without attention to the time of last food intake. Patient should be put on a carbohydrate-rich, unrestricted diet for 3 days. This is because carbohydrate-restricted diet reduces glucose tolerance. Patient should be ambulatory with normal physical activity. Absolute bed rest for a few days impairs glucose tolerance. Medications should be discontinued on the day of testing. Exercise, smoking, and tea or coffee are not allowed during the test period. Patient should remain seated. OGTT is carried out in the morning after patient has fasted overnight for 8-14 hours. A fasting venous blood sample is collected in the morning. Patient ingests 75 g of anhydrous glucose in 250-300 ml of water over 5 minutes. (For children, the dose is 1.75 g of glucose per kg of body weight up to maximum 75 g of glucose). Time of starting glucose drink is taken as 0 hour. A single venous blood sample is collected 2 hours after the glucose load. (Previously, blood samples were collected at ½, 1, 1½, and 2 hours, which is Continue reading >>

8 Important Diabetes Tests To Get Regularly

8 Important Diabetes Tests To Get Regularly

Type 2 diabetes can affect every part of your body, from your eyes to your feet. A critical part of managing diabetes is getting routine tests and checkups that can spot problems early to help prevent complications. “Too often, if someone isn’t seeing the same doctor routinely, these important tests can get overlooked,” says Diana Aby-Daniel, PA-C, a physician assistant at the Harold Schnitzer Diabetes Health Center at Oregon Health & Science University in Portland. “Many diabetes complications are preventable if they’re found early with one of these routine tests.” The following eight diabetes exams and tests will help you get the health care you need: 1. A1C test. This key blood test measures your average blood sugar levels over the previous two or three months, which lets your doctor know how well your blood sugar is being controlled. You should get this test twice a year, if not more often, according to the American Diabetes Association (ADA). “Try to get your A1C results below or as close to 7 percent as possible,” says George L. King, MD, director of research and head of the section on vascular cell biology at Joslin Diabetes Center and professor of medicine at Harvard Medical School in Boston. Talk to your doctor about the A1C goal that’s right for you. You can get this test through your primary care doctor. 2. Blood pressure checks. Diabetes makes you more likely to have high blood pressure, which can put you at increased risk for stroke and heart attack. Have your blood pressure checked every time you see your primary care doctor, Dr. King says. 3. Cholesterol test. Because having diabetes increases your risk of heart disease, it’s important to have a blood test to check your cholesterol as part of your annual exam or more frequently if your Continue reading >>

Type 1 Diabetes Mellitus Workup

Type 1 Diabetes Mellitus Workup

Laboratory Studies Plasma glucose Patients with type 1 diabetes mellitus (DM) typically present with symptoms of uncontrolled hyperglycemia (eg, polyuria, polydipsia, polyphagia). In such cases, the diagnosis of DM can be confirmed with a random (nonfasting) plasma glucose concentration of 200 mg/dL or a fasting plasma glucose concentration of 126 mg/dL (6.99 mmol/L) or higher. [2, 62] A fingerstick glucose test is appropriate in the emergency department (ED) for virtually all patients with diabetes. All fingerstick capillary glucose levels must be confirmed in serum or plasma to make the diagnosis. All other laboratory studies should be selected or omitted on the basis of the individual clinical situation. Intravenous (IV) glucose testing may be considered for possible early detection of subclinical diabetes. Individually measured glucose levels may differ considerably from estimated glucose averages calculated from measured hemoglobin A1c (HbA1c) levels. [64] Therefore, caution is urged when the decision is made to estimate rather than actually measure glucose concentration; the difference between the 2 has a potential impact on decision making. Hemoglobin A HbA1c is the stable product of nonenzymatic irreversible glycation of the beta chain of hemoglobin by plasma glucose and is formed at rates that increase with increasing plasma glucose levels. HbA1c levels provide an estimate of plasma glucose levels during the preceding 1-3 months. The reference range for nondiabetic people is 6% in most laboratories. Glycated hemoglobin levels also predict the progression of diabetic microvascular complications. American Diabetes Association (ADA) guidelines recommend measuring HbA1c at least every 6 months in patients with diabetes who are meeting treatment goals an Continue reading >>

Laboratory Diagnosis Of Diabetes Mellitus

Laboratory Diagnosis Of Diabetes Mellitus

FoldUnfold Table of Contents OBJECTIVES KEY TERMS BACKGROUND AND SIGNIFICANCE CLASSIFICATION OF DIABETES MELLITUS (NATIONAL DIABETES DATA GROUP, AMERICAN DIABETES ASSOCIATION) Type 1 Diabetes Mellitus Type 2 Diabetes Mellitus Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) Gestation Diabetes/IGT Previous Abnormality of Glucose Tolerance Maturity Onset Diabetes of the Young (MODY) Hyperglycemia Associated with Certain Conditions or Syndromes TESTS IN THE DIAGNOSIS, CLASSIFICATION AND MANAGEMENT OF DIABETES MELLITUS Determination of Blood Glucose: Where, How and When Determination of Ketone Bodies Determination of Insulin and C-peptide Glycosuria Glycylated-Hemoglobin Glycated Proteins Proteinuria Anti-Insulin Antibodies CASE STUDIES Case 1 Case 2 Case 3 Case 4 OBJECTIVES By the end of this session the reader should be able to: Describe the regulation of blood glucose Understand the analysis of blood glucose Identify appropriate laboratory tests for the diagnosis of diabetes Describe the major laboratory findings in diabetes mellitus type I Describe the major clinical findings in diabetes mellitus type I Describe the major laboratory findings in diabetes mellitus type II Describe the major clinical findings in diabetes mellitus type II Describe the differences between type 1 and type 2 diabetes mellitus Describe the laboratory and clinical findings in impaired glucose tolerance Discuss maturity onset diabetes of the young Discuss the hormonal regulation of blood glucose levels, noting what causes a decrease in concentrations and what causes an increase in concentrations Describe non-diabetic conditions in which hyperglycemia is noted Discuss appropriate sample collection for measurement of serum/plasma glucose Discuss the performance of the glucose tol Continue reading >>

3 Diabetes Tests You Must Have

3 Diabetes Tests You Must Have

Mike Ellis was fly fishing when he first noticed a change in his vision. Ellis, an avid angler, had so much trouble focusing he struggled for 20 minutes before he was finally able to get a fly on his hook, something he'd done countless times over many years of fly fishing. Then, after casting his line, he was unable to see his lure on the water. "I thought I'd scorched my eyeballs from being out in the sun too much," says Ellis, 63, a retired mechanical engineer in Denver. An eye exam the following month revealed an equally unsettling reality: Ellis had type 2 diabetes, the most common type of the disease. Years of going undiagnosed had taken a toll on his eyesight. He had diabetic retinopathy. The blood vessels in the back of his eye were damaged, a problem that often comes with the condition. "Diabetes damages every blood vessel in your body, including the ones in your eyes," says Robert Rizza, MD, professor of medicine at the Mayo Clinic. "Similar damage can also occur in your heart, your head, and your kidneys. But if you take care of yourself -- if you control your blood sugar, blood cholesterol, and blood pressure -- the chances of bad things happening to you are very low." Certainly, that's the case with Ellis. With the help of three basic tests, he has his diabetes in check. These tests can help you, too. A simple blood test, the A1c (your doctor may call it "glycosylated hemoglobin") is done on a sample of blood taken from a finger-stick or from a small vial of it drawn from your arm. Not to be confused with the daily at-home monitoring that allows some people with diabetes to measure their blood sugars in the moment, the A1c test paints a picture of your average blood sugar level for the past 3 months. If you can keep your hemoglobin A1c in the range of about Continue reading >>

Diabetes

Diabetes

Note: This article addresses diabetes mellitus, not diabetes insipidus. Although the two share the same reference term "diabetes" (which means increased urine production), diabetes insipidus is much rarer and has a different underlying cause. Diabetes mellitus is a condition in which the level of glucose (sugar) in an individual's blood becomes too high because the body cannot use it properly. This results either from an... Continue reading >>

Understanding Your Lab Test Results

Understanding Your Lab Test Results

Diabetes is a chronic condition that requires an enormous amount of self-care and that can affect many parts of the body. Because of this, people who have diabetes are generally advised to visit their doctors multiple times a year and also to see various specialists (such as endocrinologists, podiatrists, and eye doctors) periodically to screen for potential problems and treat any complications that arise. Along with blood pressure readings and inspection of the feet and eyes, there are a number of laboratory tests recommended by the American Diabetes Association. These tests are used to track blood glucose control, kidney function, cardiovascular health, and other areas of health. Although you certainly can’t and won’t be expected to analyze the lab report when your test results come back, knowing a little bit about what your report says can be a way for you to more fully understand and take charge of your health. If it isn’t already your doctor’s regular practice to give you copies of your lab reports, ask for a copy the next time you have lab tests done. Use the information in this article to learn more about what lab reports show, and discuss your results with your doctor to learn what your results mean with regards to your health. Lab reports All lab reports share certain standard features, regardless of the test(s) they show. A Federal law, the Clinical Laboratory Improvement Act, regulates all aspects of clinical laboratory testing. It states exactly what information must be included in your lab test report. Some of the standard features include the following: • Your name and a unique identification number, which may be either your birth date or a medical record number assigned to you by the lab. • The name and address of the lab that tested your bloo Continue reading >>

Laboratory Tests For Diagnosis And Management Of Diabetes

Laboratory Tests For Diagnosis And Management Of Diabetes

Tests that measure the levels of glucose in blood and urine are essential to the diagnosis and management of diabetes mellitus. Because blood glucose levels are affected by several factors, proper patient and sample preparation are important. Early diagnosis and control of diabetes can help reduce patient morbidity and mortality. Diabetes mellitus is a chronic metabolic disorder characterized by persistently high blood glucose levels (hyperglycemia). It may be congenital or acquired. In small animals, the acquired form is more common and usually occurs in middle-aged dogs and cats. Regardless of the etiology, patients with diabetes mellitus have excess glucose in their blood and low levels of glucose in most body cells. Patients receiving insulin for diabetes require periodic testing to monitor disease progression and to evaluate the effectiveness of therapy and client compliance. Diabetes mellitus is usually diagnosed based on the patient's history and clinical signs and the results of several blood and urine tests. Numerous conditions, including pancreatic trauma, neoplasia, and infection, may contribute to the onset of the disease (SEE BOX).1 Common clinical signs of diabetes mellitus include polydipsia, polyuria, and polyphagia. Weight loss, restlessness, ataxia, disorientation, and weakness may also occur. Patients that develop ketoacidosis may present with tachycardia, seizures, and Kussmaul's respiration (rapid, deep, labored breathing). Most tests used in the diagnosis of diabetes measure the level of glucose in the patient's blood. Normal blood glucose levels vary among species, but individual healthy animals tend to have relatively stable glucose levels because the body's normal homeostatic mechanisms, such as insulin release, maintain glucose within a very na Continue reading >>

Blood Tests For Diabetes: Oral Glucose Tolerance Test

Blood Tests For Diabetes: Oral Glucose Tolerance Test

Also known as: OGTT; 2-hour glucose tolerance test. What is it? A test that measures blood glucose levels before and 2 hours after you drink an oral dose of glucose solution (75 to 100 grams of an extremely sweet drink), which should cause glucose levels to rise in the first hour, then fall back to normal within two hours as the body produces insulin to normalize glucose levels. Test results show how well your body is able to process glucose. Why is this test performed? To confirm a diagnosis of diabetes or gestational diabetes (and to diagnose other metabolic diseases). Because the OGTT is a more sensitive test than the fasting plasma glucose test, and involves multiple blood draws to monitor insulin production, it can often detect cases of diabetes that may be missed by the fasting test. How is the oral glucose tolerance test performed? The OGTT is typically performed in the morning, after you’ve fasted for at least eight hours. Your blood will be drawn to measure your fasting blood sugar level. You will then be given the sugary solution to drink, and your blood sugar levels will be tested periodically over the next two hours. How frequently should this test be performed? Once, in select individuals, for diagnosis of diabetes. A second retest may be appropriate in some patients, particularly pregnant women being tested for gestational diabetes. Additional laboratory tests may be required for an accurate diagnosis. What is the “normal” range for results? While laboratory test methods and measurements can vary for this test, normal OGTT results in those who are not pregnant are as follows: Fasting: 60 mg/dl to 99 mg/dl (3.3 mmol/l to 5.5 mmol/l) 1 hour: Less than 200 mg/dl (11.1 mmol/l) 2 hours: Less than 140 mg/dl (7.8 mmol/l) Factors such as age, weight, and rac Continue reading >>

Symptoms, Diagnosis & Monitoring Of Diabetes

Symptoms, Diagnosis & Monitoring Of Diabetes

According to the latest American Heart Association's Heart Disease and Stroke Statistics, about 8 million people 18 years and older in the United States have type 2 diabetes and do not know it. Often type 1 diabetes remains undiagnosed until symptoms become severe and hospitalization is required. Left untreated, diabetes can cause a number of health complications. That's why it's so important to both know what warning signs to look for and to see a health care provider regularly for routine wellness screenings. Symptoms In incidences of prediabetes, there are no symptoms. People may not be aware that they have type 1 or type 2 diabetes because they have no symptoms or because the symptoms are so mild that they go unnoticed for quite some time. However, some individuals do experience warning signs, so it's important to be familiar with them. Prediabetes Type 1 Diabetes Type 2 Diabetes No symptoms Increased or extreme thirst Increased thirst Increased appetite Increased appetite Increased fatigue Fatigue Increased or frequent urination Increased urination, especially at night Unusual weight loss Weight loss Blurred vision Blurred vision Fruity odor or breath Sores that do not heal In some cases, no symptoms In some cases, no symptoms If you have any of these symptoms, see your health care provider right away. Diabetes can only be diagnosed by your healthcare provider. Who should be tested for prediabetes and diabetes? The U.S. Department of Health and Human Services recommends that you should be tested if you are: If your blood glucose levels are in normal range, testing should be done about every three years. If you have prediabetes, you should be checked for diabetes every one to two years after diagnosis. Tests for Diagnosing Prediabetes and Diabetes There are three ty Continue reading >>

Tests For Blood Sugar (glucose) And Hba1c

Tests For Blood Sugar (glucose) And Hba1c

Blood sugar (glucose) measurements are used to diagnose diabetes. They are also used to monitor glucose control for those people who are already known to have diabetes. Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. If your glucose level remains high then you have diabetes. If the level goes too low then it is called hypoglycaemia. The main tests for measuring the amount of glucose in the blood are: Random blood glucose level. Fasting blood glucose level. The HbA1c blood test. Oral glucose tolerance test. Capillary blood glucose (home monitoring). Urine test for blood sugar (glucose). Blood tests for blood sugar (glucose) Random blood glucose level A sample of blood taken at any time can be a useful test if diabetes is suspected. A level of 11.1 mmol/L or more in the blood sample indicates that you have diabetes. A fasting blood glucose test may be done to confirm the diagnosis. Fasting blood glucose level Continue reading >>

V. Routine And Optional Laboratory Tests For The Investigation Of Patients With Hypertension

V. Routine And Optional Laboratory Tests For The Investigation Of Patients With Hypertension

PreviousNext Subgroup Members: Thomas Wilson, MD; S. Brian Penner, MD; Ellen Burgess, MD; Praveena Sivapalan, MD Central Review Committee: Stella S. Daskalopoulou, MD, PhD; Kaberi Dasgupta, MD, MSc; Kelly B. Zarnke, MD, MSc; Kara Nerenberg, MD, MSc; Alexander A. Leung, MD, MPH; Kevin C. Harris, MD, MHSc; Kerry McBrien, MD, MPH; Sonia Butalia, BSc, MD; Meranda Nakhla, MD, MSc Chair: Doreen M. Rabi, MD, MSc This information is based on the Hypertension Canada guidelines published in Leung, Alexander A. et al. Hypertension Canada’s 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults. Can J Cardiol 2017; 33(5): 557-576. Guidelines Routine laboratory tests that should be performed for the investigation of all patients with hypertension include: Urinalysis (Grade D); Blood chemistry (potassium, sodium, and creatinine) (Grade D); Fasting blood glucose and/or glycated hemoglobin (A1c) (Grade D); Serum total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), non-HDL cholesterol, and triglycerides (Grade D); lipids may be drawn fasting or non-fasting (Grade C). Standard 12-lead electrocardiography (Grade C). Assess urinary albumin excretion in patients with diabetes (Grade D). All treated hypertensive patients should be monitored according to the current Diabetes Canada guidelines for the new appearance of diabetes (Grade B). During the maintenance phase of hypertension management, tests (including those for electrolyte, creatinine, and fasting lipids) should be repeated with a frequency reflecting the clinical situation (Grade D). Background 1. Routine laboratory tests that should be performed for the investigation of all patients with hypertension include: i. Urinalysis (Grade D); ii. Blood chemistry (potassiu Continue reading >>

Diabetes Urine Tests

Diabetes Urine Tests

Urine tests may be done in people with diabetes to evaluate severe hyperglycemia (severe high blood sugar) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient insulin to use glucose for energy. Urine tests are also done to look for the presence of protein in the urine, which is a sign of kidney damage. Urine glucose measurements are less reliable than blood glucose measurements and are not used to diagnose diabetes or evaluate treatment for diabetes. They may be used for screening purposes. Testing for ketones is most common in people with type 1 diabetes. Type 1 Diabetes: What Are The Symptoms? This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur. Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones. The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time. Can urine tests be used to Continue reading >>

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