Best Laboratory Tests For Diagnosis of Diabetes Mellitus

History and physical examination are most important tools for diagnosing diabetes Mellitus, however to confirm diagnosis one should have following laboratory tests.



Urine sugar test



Urine ketones test



OGTT-Oral Glucose Tolerance Test, (also called glucose challenge test)



Blood glucose tests



FPG-Fasting plasma glucose Test



Random plasma glucose Test



Tests for ongoing monitoring of diabetes control:
HbA1c blood test - an average blood sugar measure over about 3 months.
Fructosamine blood test - an average blood sugar measure over about 2 weeks



It is not necessary that one should have all the tests given in above list, but it is necessary to diagnose your disease if you want best treatment for your illness.



How frequently a person must check his sugar level is the decision of your doctor. It mainly depends upon patients age and number of risk factors like blood pressure, higher cholesterol or smoking. If you are above 45 years then you should have your blood sugar level after every 3 years. Even if you are below 45 years and have one or more risk factors then you should also check your blood sugar level frequently.



A- Urine sample for sugar and Ketones:
You may have your urine analysis for sugar or ketones which are produced by breakdown of fat and muscle cells to diagnose diabetes but you should keep in mind that if you are having positive urine test for sugar then it is not necessary that you are suffering from diabetes because there are other conditions as well which also cause sugar to appear in urine.



B-THE FASTING BLOOD GLUCOSE (SUGAR) TEST
For diagnosing Diabetes Mellitus one must have this test because it is best, easy and comfortable to perform. You should have overnight fast (at-least 8 hours) before performing this test. If fasting blood glucose is below 100mg/dl, then you don't have diabetes. Between 100mg/dl to 125mg/dl is called a Pre-diabetes or Impaired fasting glucose condition. If fasting blood glucose is above 126mg/dl on more than two occasions then you are suffering from diabetes.



C-RANDOM (NON-FASTING) BLOOD GLUCOSE TEST
It is also a good test for diagnosing diabetes. In this test we take sample of blood shortly after taking a meal and then check glucose level in blood. If this level is above 200mg/dl, then there are much chances that you are suffering from diabetes. But diagnosis should be confirmed the very next day by fasting blood glucose or by glucose tolerance test



D-ORAL GLUCOSE TOLERANCE TEST (OGTT):
Though this test is not commonly used these days but it is still a gold standard for diagnosing diabetes. For diagnosing gestational diabetes this is best test.



Instructions for OGTT:
This is test for a person who is in good health and have no other illness.
Person should be normally active and not bed ridden.
Person is not taking anti diabetic drugs or any drug which alters blood sugar level.
Before test, person should eat high carbohydrate diet for three days.
No alcoholic beverages.
On test day one should not smoke or take coffee.



Glucose Tolerance Test Procedure:
First normal blood glucose is tested. Then person drinks 75gm of glucose, for pregnant woman dose of glucose is 100 gm. Then blood samples are taken at particular intervals for measuring blood glucose level.Blood glucose level is measured five times over a period of 3 hours. In simple words, in normal person, this blood sugar level gets higher value by taking 75gm of glucose, however it falls down quickly, but in person having diabetes the blood sugar level rises higher than normal but does not come down quickly. If a person have fasting blood glucose above 140mg/dl and 2 hours value after 75gm of oral glucose greater than 200mg/dl and considered as diabetics. If 2 hours blood glucose value between 140-200mg/dl is labeled as Pre-diabetic condition or impaired fasting glucose. During pregnancy, 2 hours blood glucose value between 140-200mg/dl is treated as a case of diabetes.



OTHER TESTS
Glycosylated haemoglobin Test or HB A1 Test:
Very important test which tells you how good you are in controlling your blood sugar. It shows your blood sugar control during the past 2 to 3 months. For normal individuals, a good hemoglobin A-1-c is 7 percent.



Intravenous GTT:
This test is performed in indviduals who have intestinal disease or malabsorption.



Extended GTT:
In this the oral Glucose Tolerance Test is extended to 3-4 hours rather than 2 hours, for appearance of symptoms of hyperglycaemia.



In short if your fasting blood glucose is more than 126mg/dl on two or more days, or your random blood glucose is above 200mg/dl or your oral glucose tolerance test is positive i.e 2 hours blood glucose value between above 200mg/dl after 75gm of glucose, then you are suffering from Diabetes Mellitus.

What Are the Best Laboratory Tests for the Diagnosis of Diabetes Mellitus?

Diabetes mellitus is being detected more frequently in today's society, and it can affect both children and adults. Causation between age groups may vary, yet it is a serious disease that requires constant care. Contracting Type 1 diabetes, also known as "childhood onset," will display symptoms such as frequent urination, excessive thirst, and clamminess or sweatiness. This affliction becomes apparent when the pancreas, an organ that secretes insulin into the body, ceases to function. Insulin is a hormone that, when distributed efficiently, regulates glucose levels. When the pancreas no longer works properly, diabetes occurs.



A Diabetic specialist or endocrinologist will run a blood test to determine average blood sugar levels over the previous 2 to 3 months. This test is called "A1C hemoglobin," and it will help determine if the patient has Type I or Type II diabetes. Type I requires insulin injections and Type II can be dealt with a few different ways, depending upon severity. Often times, oral medication is prescribed, yet in some rare cases it can be eradicated by diet and exercise.



Either way, the patient will need to obtain a glucose monitor and use it regularly until the condition is manageable. Checking blood sugar levels on a daily basis will take some getting used to, yet performing this task regularly can help save the patient from suffering adverse effects from the disease. Neglect is not an option; testing 3 to 4 times daily is recommended.



Most monitors require a small drop of blood from the fingertip or the inside of the forearm. The sample is then applied to a test strip that is inserted into the monitor itself, and within 5 seconds, a number will appear. An average healthy reading will range from 80 to 130 mg/dl (milligrams of glucose per deciliter of blood). Results will often vary; most physicians will concur that staying within these guidelines can promote better overall health, yet consulting with a diabetic specialist is the best advice. A trained physician will be able to show the patient a variety of glucose monitors that use different sized lithium batteries. The test strips vary in size as well, and they are only compatible with the same brand of meter. Written records of the daily results should be kept. Most glucose monitors will come with a miniature log book, which can help both doctor and patient when it is time for the next visit.