Guide To Lab Tests


#1

I’ve spent all morning looking around for some sort of Guide to Lab Tests, something that tells me what labs I should be having done every 3 months, and so far I’ve had no success.

Can anyone point me in the right direction?


#2

Stacey,

Typically people with diabetes would get an A1c test every 3 months.

If you have kidney issues, your doctor might want to run a microalbumin test or a 24 hour urine collection test to see how your kidneys are doing.

If you are taking a medication that can affect the liver, for example, a statin drug, your doctor might run liver function tests (SGOT etc).
http://en.wikipedia.org/wiki/Liver_function_tests.

If you have thyroid issues, there are a couple thyroid tests that might be performed. TSH, free T-3.

If you are on Metformin, your doctor should run a Vitamin B-12 test once a year.

But most doctors don’t run a lot of tests every three months. Once a year is more typical, and many insurance companies may have guidelines that limit what tests they will pay for.

Fortunately, you can run a BLOOD SUGAR METER TEST at home after you eat and get much more helpful information from that than you will from any other lab test.

Read this page to learn how to use the meter test to normalize your blood sugar: http://alt-support-diabetes.org/newlydiagnosed.htm


#3

Or this from the Mayo Clinic about tests for blood sugar:

http://www.mayoclinic.com/health/blood-sugar/SA00102


#4

Oh I know I wasn’t very specific…heres the deal.
I’ve been diabetic for a long time…17 almost 18 years actually…Type 1 and with regard to my D, I’m only taking insulin.

I get a battery of blood work done every 3 months for my endo…A1C etc etc.

What I’m looking for is a list of all the tests that we should be having done every 3 months in my case, every year for soem others.

It would include the A1C for sure, but what else?

I’m trying to find out whats recommended vs what I’m actually having done…sort of checking up on my check ups. Make sure everything is in the right place.

I have a list like that for my Still’s/RA that I got through the Arthritis Foundation but I cant seem to find the same type of list with regard to my D.


#5

Here’s a link to the list the ADA has. It’s not very detailed. It says things like “look for protein in urine” instead of teling you the name of the test, but it also mentions things like looking at your feet which isn’t a blood test at all. Also, it doesn’t mention the eye doctor or other doctors you may need to visit.

http://www.diabetes.org/whos-who-on-your-health-care-team/future-vi…


#6

Here is something that you might want to take a look at.

http://www.mayoclinic.com/print/diabetes-lab-tests/DA00104/METHOD=print

Florian


#7

Good for you! That’s so great that you are proactive and “checking up on your checkups”. We all need to be reminded that drs. make mistakes and need to be questioned. The computer at my clinic reminds my doc of every thing that needs to be done, but, I always check it a second time. I keep all of my lab test results in an old fashioned accountant’s ledger (yes, I could do them on excel, but somehow I just like writing them down).


#8

Here’s some recommendations I copied & pasted from the ADA “Standards of Medical Care”. The letter at the end of each line is a grade of the amount of evidence supporting the importance of this (A = clear evidence, B = supportive evidence, C = supportive evidence from poorly controlled studies, E = expert consensus).

Blood pressure should be measured at every routine diabetes visit. Patients found to have systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg should have blood pressure confirmed on a separate day. ©

test for lipid disorders at least annually and more often if needed to achieve goals. In adults with low-risk lipid values (LDL <100 mg/dl, HDL >50 mg/dl, and triglycerides <150 mg/dl), lipid assessments may be repeated every 2 years (E)

Perform an annual test for the presence of microalbuminuria in type 1 diabetic patients with diabetes duration of ≥5 years (E)

Serum creatinine should be measured at least annually for the estimation of glomerular filtration rate (GFR) in all adults with diabetes regardless of the degree of urine albumin excretion (E)

Adults and adolescents with type 1 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist within 3–5 years after the onset of diabetes. (B)

Subsequent examinations for type 1 and type 2 diabetic patients should be repeated annually by an ophthalmologist or optometrist. Less frequent exams (every 2–3 years) may be considered in the setting of a normal eye exam. Examinations will be required more frequently if retinopathy is progressing. (B)

All patients should be screened for distal symmetric polyneuropathy (DPN) at diagnosis and at least annually thereafter, using simple clinical tests. (A)

Electrophysiological testing is rarely ever needed, except in situations where the clinical features are atypical. (E)

Once the diagnosis of DPN is established, special foot care is appropriate for insensate feet to decrease the risk of amputation. (B)

Perform a comprehensive foot examination and provide foot self-care education annually on patients with diabetes to identify risk factors predictive of ulcers and amputations. (B)

The foot examination can be accomplished in a primary care setting and should include the use of a monofilament, tuning fork, palpation, and a visual examination. (B)

A multidisciplinary approach is recommended for individuals with foot ulcers and high-risk feet, especially those with a history of prior ulcer or amputation. (B)

Refer patients who smoke or with prior lower-extremity complications to foot care specialists for ongoing preventive care and life-long surveillance. ©

Initial screening for peripheral arterial disease (PAD) should include a history for claudication and an assessment of the pedal pulses. Consider obtaining an ankle-brachial index (ABI), as many patients with PAD are asymptomatic. ©

Simple inspection of insensate feet should be performed at 3- to 6-month intervals. An abnormality should trigger referral for special footwear, preventive specialist, or podiatric care. (B)

Screening for autonomic neuropathy should be instituted at diagnosis of type 2 diabetes and 5 years after the diagnosis of type 1 diabetes. Special electrophysiological testing for autonomic neuropathy is rarely needed and may not affect management and outcomes. (E)


#9

That was very helpful. Thanks.


#10

Thanks; I just got my first lab back with a positive reading for “Micral Albumin” and I didn’t know what the acceptable range was. If I read this correctly I’m still in the normal zone (assuming its listed as Urine microalbumin test in the article - my lab report stated a value of “20”) I will take it as a yellow flag anyway.

Does anyone know why I might be positive for Micral Albumbin (20) but have low Albumin (3.4)?