Diabetes Panel

This panel includes important tests usually prescribed for anyone living with Type 1 or Type 2 diabetes. It includes A1c, CMP, Urinalysis, Insulin and Glucose Tolerance Test (GTT)- 2 samples.

Diabetes is a group of diseases that result in blood sugar (glucose) levels that are too high.

Type 1 Diabetes is characterized by the body failing to produce insulin.

Type 2 Diabetes is characterized by failing to produce enough insulin for proper function or by the body not reacting to insulin. Approximately 90 percent of diabetes cases are Type 2.

Gestational diabetes affects pregnant women. It occurs when their bodies have very high glucose levels and not enough insulin to transport it into cells. Often women with gestational diabetes have no symptoms, so testing is important if you are considered an at-risk patient.

A1C Test

The A1c test works by measuring the hemoglobin A1c level. Hemoglobin is stored in the red blood cells. When glucose levels are high, the sugar starts to combine with the hemoglobin. It takes the body 8 to 12 weeks to bring hemoglobin A1c levels back to normal. Therefore, if hemoglobin A1c levels are high, that means that there has been a high level of glucose in the blood over the last 2 to 3 months.

Comprehensive Metabolic Panel (CMP):

Let's go over the cmp blood tests :

The Serum Glucose test: Serum glucose levels may be high due to diabetes mellitus, strenuous exercise, increased epinephrine, pancreatic disease or an endocrine disorder. A high serum level may also be related to acute myocardial infarction or severe angina, chronic liver disease, or chronic renal disease.

The Uric Acid test: High uric acid levels may indicate gout, renal failure, leukemia, lymphoma, psoriasis, polycythemia, multiple myeloma, kidney disease, and or chronic lead nephropathy. Associated with hyperlipidemia, obesity, hypertension, arteriosclerosis, diabetes mellitus, hypoparathyroidism, acromegaly, and liver disease.

The BUN, Blood Urea Nitrogen, can be abnormal in kidney disease, dehydration, and heart failure, as well as malnutrition and liver disease.

The Serum Creatinine is a measure of kidney function. The BUN to Creatinine ratio can give information on the possible cause of the kidney dysfunction, say heart failure or dehydration or decreased kidney blood flow

The Serum Sodium can be increased in dehydration. The Serum Sodium can be decreased in diuretic therapy and in the syndrome of inappropriate antidiuretic hormone abbreviated, SIADH.

The Serum Potassium can be increased in adrenal insufficiency and acute renal failure, as well as with an inappropriate combination of medicines. Potassium could be decreased in primary aldosteronism, diuretic therapy, and renal tubular acidosis.

The Serum Chloride: High chloride levels may be attributed to dehydration, renal tubular acidosis, acute renal failure, diabetes insipidus, metabolic acidosis associated with prolonged diarrhea with loss of nahco3, respiratory alkalosis, and some cases of primary hyperparathyroidism. Low serum chloride levels may be due to excessive sweating, prolonged vomiting from any cause or gastric suction, persistent gastric secretion, salt-losing nephritis, aldosteronism, potassium depletion associated with alkalosis, respiratory acidosis

Carbon Dioxide: High levels may indicate respiratory acidosis caused by poor gas exchange or depression of respiratory center; generalized respiratory disease; metabolic acidosis (after severe vomiting in pyloric stenosis, hypokalemic states, or excessive alkali intake). Low levels may indicate compensated respiratory alkalosis, metabolic acidosis in diabetes mellitus, renal glomerular or tubular failure, renal tubular acidosis and intestinal loss of alkali with coexisting increase in c1 and normal anion gap

Serum Calcium: High blood calcium levels may indicate primary and tertiary hyperparathyroidism, malignant disease with bone involvement (in particular metastatic carcinoma of the breast, lung, kidney, multiple myeloma, lymphomas, and leukemia), vitamin d intoxication, milk-alkali syndrome, Paget’s disease with immobilization, thyrotoxicosis, acromegaly, diuretic phase of acute tubular necrosis or dehydration. Low levels of calcium may indicate hypoparathyroidism; vitamin d deficiency, chronic renal failure, magnesium deficiency, prolonged anticonvulsant therapy, acute pancreatitis, anterior pituitary hypofunction, hypoalbuminemia, or inadequate nutrition.

Serum Phosphorus can be increased in acute or chronic renal failure and decreased in malabsorption and vitamin D deficiency. Serum phosphorus concentrations have a circadian rhythm (highest level in late morning, lowest in evening) and are subject to rapid change secondary to environmental factors such as diet (carbohydrate), phosphate-binding antacids, and fluctuations in growth hormone, insulin, and renal function. High levels may indicate osteolytic metastatic bone tumors, myelogenous leukemia, milk-alkali syndrome, vitamin d intoxication, healing fractures, renal failure, hypoparathyroidism, pseudohypoparathyroidism, diabetes mellitus with ketosis, acromegaly, portal cirrhosis, pulmonary embolism, lactic acidosis or respiratory acidosis.

The total Serum Protein can be increased in multiple myeloma and sarcoidosis, and it can be decreased in chronic glomerulonephritis, which is a type of chronic renal disease.

The Serum Albumin can be decreased in liver disease, cirrhosis, and in nephrotic syndrome. The total Globulin and the Albumin to Globulin ratio can be increased or decreased due to a number of causes.

The total Bilirubin can be increased in hepatitis, hemolytic anemia, and in blockage of the bile ducts, either the bile ducts within the liver or within the bile duct that drains the gallbladder and the liver. That's what we mean when we say cholestasis or biliary obstruction. The direct Bilirubin is increased in the same things as the total Bilirubin, but the ratio of direct to total gives us clues as to the causes. One of the most common causes of a mildly elevated total Bilirubin found on a routine CMP is a syndrome called Gilbert's disease. Although it's called a disease, it's common, and it doesn't cause any liver damage or any health damage.

The Alkaline Phosphatase can be increased in bone disease and liver disease and decreased in malnutrition and celiac disease.

The AST, and ALT are often called liver enzyme tests. They don't measure liver function, but rather give evidence of liver damage, but they can also be elevated in damage to other parts of the body. They can be increased in liver disease, muscle disease, pancreatitis, and excessive exercise.

Urinalysis

The Urinalysis test panel screens for a variety of conditions including urinary bladder disease, kidney disease and diabetes. Tests included: Color, Appearance, Specific gravity, pH, Protein, Glucose, Occult blood, Ketones, Leukocyte esterase, Nitrite, Bilirubin, Urobilinogen, and Microscopic examination of urine sediment.

About one-third of people with diabetes have problems with their kidneys. But early and tight control of your blood sugar and blood pressure, plus help from certain medications, can keep these organs working like they should. To check for problems, this test measures if protein is present in your urine, called microalbuminuria. It shows up when small amounts of albumin (the main protein in your blood) seep into your pee. Without treatment to slow the leak (usually blood pressure medications), your kidneys could be damaged and eventually fail.

Insulin Level

Insulin is a substance produced by the pancreas to help stabilize blood sugar levels. This substance acts as a "key" that opens up the cells in your body, allowing them to absorb glucose and use it for energy production.

A typical insulin blood level between meals is 8–11 μIU/mL (57–79 pmol/L)

Glucose Tolerance Test (GTT), Two-hour

The glucose tolerance test is a medical test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood. The test is usually used to test for diabetes, insulin resistance, impaired beta cell function, and sometimes reactive hypoglycemia and acromegaly, or rarer disorders of carbohydrate metabolism. In the most commonly performed version of the test, an oral glucose tolerance test (OGTT), a standard dose of glucose is ingested by mouth and blood levels are checked two hours later.