What are the laboratory tests

  1. What are the laboratory tests (blood tests) that should bemonitored in a patient with diabetes mellitus? What are the normalvalues?
  1. What is the relationship between diabetes mellitus and renalfailure?

Answer:

The investigations that need to be done include:

  • Fasting blood sugar: a value more than 100 indicates insulinresistance while a value more than 126mg/DL indicates diabetes.Normal value is less than 100
  • Post prandial blood sugar: 2 hours after meal- value. A valuemore than 140 indicates insulin resistance and more than 200indicates diabetes. Normal value is less than 140.
  • Hba1c: more reliable estimate of long term glycemic control.Glucose in blood binds with hemoglobin of RBCs. Since RBCs have alife span of 120 days, HbA1c is thought to be a good estimate ofglucose control over past 3 months. Normal value is less than 5.7%,5.7 to 6.5% indicates prediabetes and more tha. 6.5% indicatesdiabtes.
  • Renal function tests and serum electrolytes. Since diabetes isa cause of chronic kidney disease, RFT and serum electrolytesshould be monitored from time to time. S. Creatinine values till1.5 are considered normal in most.

Diabetes is a prominent cause of chronic disease. Diabetes isassociated with microvascular complications which include diabeticnephropathy, diabetic retinopathy and diabetic neuropathy.

These occur due to intracellular sorbitol accumulation,accumulation of abnormal end glycosylation products, free radicaldamage etc.

These changes accumulate over time and cause chronic failure ofthe kidneys. Good blood sugar control can prevent this.


 
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