Tests for diabetes!

Tests for diabetes!

In addition of regular test of FBS,PPBS and RBS,

1)Which tests are required for a diabetic person?

2)Can we categorize these tests as essential,regular and optional?

3)What should be respective frequencies of these tests in a year?

4)What pre-cautions are needed for these test?

5)Is it useful to go for these tests each time in the same lab?

Please reply!

19 Replies

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  • As a type II patient for last 15 years I will put my comments as follows:

    1. First determine , how is your diabetes , is it in control or slightly higher side or higher side ? Secondly do you have any other ailment like blood pressure ?

    If the answers are yes to higher diabetes with other disorders then first you need to take medication and check your sugar level fortnightly at home and alternate months in LAB.

    You may change the LAB if you yourself find it uncomfortable . I would go where equipments are modern.

    Once in a year full clinical check up would help and for tests doctors would ask you how to come prepared for the test.

    Lastly instead of worrying too much we have to take care.

    All the best

  • Dear cnt22,Thanks a lot for your reply.No doubt,you have a long experience of diabetes.People like you are hope and inspiration for me as I am just learning to manage diabetes.

    My diabetes is of type-II.

    Following are mine tests reports:

    Test date:26.08.2015 (more than 2 months ago)

    FBS-107.9 and PPBS (2 hrs)-144.7

    Ser cholesterol-136,HDL-50,LDL-65,VLDL-21,Trig-140,Blood

    urea-24.6,Creat-1.1,HbA1c-7.65,Albumin-Nil,Urine Ph-6

    Please give your valuable comment on the above report!

    From helping hands in this forum,especially Anup Ji,I learned useful things to manage my diabetes.I do not take any medicine except an ayurvedic churna twice a day.Now,I follow low-carb diet with some good fats (Virgin coconut oil,Coconut milk,Cheese and Black coffee with no sugar) and I am feeling better.

    I request you to further clarify the following:

    1)What is full clinical check up?

    2)How do you manage your diabetes?

    I will be thankful to your for the same.

  • (1) Get A1C/LIPIDS/KFT/LFT/Cardiac Markers/Thyroid done every year for two years if on LCHF diet.

    (2) Regularly and aggressively monitor PPBS/FBS at home. If can, then monitor BP also at home. I always lay more stress on PPBS.

    (3) If 2 is giving great numbers you can start skipping annual tests to once in 2 years. In fact, it has been more than 2 years now that I have done annual tests. In fact, I haven't even tested PPBS/FBS at home since last two months. I know what will spike and what will not based on more than four years of experience on LCHF diet and ZERO drugs.

    If, however, you are on HIGH CARB LOW FAT nonsensical diet, then you may have to test every six months, everything :)

  • Liver and Kidney function tests.

  • For pancreas -- I think it is going to be test for levels of pancreatic enzyme. I am not too sure on this as I have never got it done myself. But, logically unless one is going into unexplained and repeated HYPOS, i don't think pancreas should be of major concern. I could be wrong as just intrapolating/extrapolating on this.

    Liver - LFT on blood sample will cover everything necessary. If something abnormal shows up, then that would be followed by scans.

    Insulin test in India is around Rs 400 ie ~$6.

    Fasting insulin, fasting BG should be enough to compute IR. Indirect way would be TG/HDL ratio, but that would just be indicative. Good at least India is free from this Insurance - Medicare nexus. Here insurance is against hospitalization for emergency procedures normally.

    We can order whatever tests we want even if doctor is not interested. One call to thyrocare eliminates all the need for talking to doctors for recommending any blood tests.

    For my age, an insurance of Rs 3 lacs (for hospitalization and emergency procedures) would cost $160/year, give or take a few dollars.

  • Dear Anup JI,I am always thankful to you for all your support!

    Now,I follow low-carb diet with some good fats (Virgin coconut oil,Coconut milk and Cheese) and also black coffee with no sugar and I am feeling much better.

    However,my present situation is much better than past but I still monitor my blood sugar level regularly.I request you to go through the following:

    Date:05.11.2015

    FBS ( 9 hrs after dinner)-91,PPBS (30 min)-145,PPBS (1hr)-130,PPBS (1 hr 30 min)-114 and PPBS (2 hrs)-106

    On the basis of similar tests conducted during breakfast,lunch and dinner on several consecutive days with different food items (as par Low Carb-High Fat diet), the following results are obtained:

    FBS-From 85 to 100 and PPBS (30 min-1hr)-125 to 155 and PPBS (1hr-2 hrs)-100 to 125

    Min-85 & Max-155

    Now,I request you to clarify the following:

    1)Is my blood sugar under control?

    or I need more attention.

    2)Is it possible to get better results in the future?

    by following the same diet and life style.

    3)Can I expect more improvement in my eye sight?

    as other complications have been gone off.

    4)Further weight reduction would be useful?

    at present my weight is 90 kg and height is 188 cm.

    5)How can I manage my diabetes in a better way?

    shall I go for medicines.

  • (1) All control is good. Stick to whatever you are doing and no need to measure sugar levels at 30/45/60/90 minutes, unless you test with something new.

    (2) Eye sight - Astaxanthin 6 mg (supplement) once a day. But, it is said that astaxanthin depletes calcium so will have to be taken with calcium so this will be tricky. I had tried this in 2011 (if you check my old posts) but dropped it as i wasn't too keen on taking calcium supplements back then.

    As for improvement in eye sight wrt power, I doubt. Aim should be not to let it deteriorate from present condition as far as possible.

    (3) Drugs - No, not needed. Many on drugs can my dream of what you have achieved without drugs all because of LCHF Diet :)

  • Thanks a lot,once again!

  • Thanks a lot!

  • Dear champak045,Thanks a lot for your detailed reply!

    RBS is random blood sugar.

    Following are mine tests reports:

    Test date:26.08.2015 (more than 2 months ago)

    FBS-107.9 and PPBS (2 hrs)-144.7

    Ser cholesterol-136,HDL-50,LDL-65,VLDL-21,Trig-140,Blood

    urea-24.6,Creat-1.1,HbA1c-7.65,Albumin-Nil,Urine Ph-6

    Please give your valuable suggestions on the basis of above report!

  • Yes,it is Rs 500 at my place too!

  • So sad!

  • It is too much in USA!

  • Got it!

  • In addition to FBS,PPBS,you may check for Lipid Profile(i.e. Good Cholestrol HDL and Bad Cholestrol LDL) once in 6 months(if problem may be once in 3 months),Serum Creatinine-for kidney function(once in 6 months).

  • Thanks a lot for your advice!Please go through following:

    Patient details:Age-44 years,Gender-Male,Height-188 cm,Weight-90 kg

    Diabetic since 2009 (approx 6 years)

    Today's blood pressure readings:110/70

    Please go through these reports and clarify the following:

    1)How is the overall health condition?

    2)Is there improvement in overall health?

    3)Is there need of further attention?

    *Test date:18.05.2015

    HbA1c-6.98

    Serum Cholesterol-106,HDL-48,LDL-40,VLDL-18,Triglycerides-138,Blood Urea-27.8,Creatinine-1.2,Urine specific gravity-1.03,pH-6+

    **Test date:26.08.2015

    HbA1c-7.65

    Serum Cholesterol-136,HDL-50,LDL-65,VLDL-21,Triglycerides-140,Blood Urea-24.6,Creatinine-1.1,Urine specific gravity-1.02,pH-6

    ***Test date:16.11.2015

    HbA1c-6.56

    Serum Cholesterol-168,HDL-48,LDL-96,VLDL-24,Triglycerides-116,Blood Urea-19.2,Creatinine-1.0,Urine specific gravity-1.02,pH-6+

  • I guess this is case of IR.....

    Look at TG to HDL ratios.

    on 18/5/2015-----HBa1c 6.98 and TG to HDL------ 2.87

    on 26.08.2015----HBa1c  7.65 and TG to HDL------2.80

    on 16.11.2015----HBa1c  6.56and TG to HDL------2.41

    As soon as ratio of TG to HDL falls under 2 HBa1c improves...

    As Anupjee rightly mentioned...this ratio is indicative  of insulin resistance.As that improves your body will utilize available insulin more efficiently and HBa1c will fall.

  • Yes TG/HDL is indirect way to look at Insulin Resistance.

    Only way to decrease TG is to cut down carbs drastically to 20%.

    Ideally, fasting insulin should be close to lowermost value of the lab range.

  • As far as Laboratory is concerned,please look for NABL accredited laboratory.

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