19 + 20. Evaluation of gliycemia for preceded period of time | Selection of clinical laboratory tests in detecting and tracking disturbance of carbohydrate metabolism in patients w/ DM Flashcards
What is Glycosylated Hemoglobin?
Aka Glycohemoglobin, HbA1c
When Glucose molecules attach to HbA = Glycosylation
When Must HbA1c NOT BE USED for Diagnosis?
Pregnant Women
Recent Severe Bleeding
Blood Transfusion
Chronic Kidney / Liver Disease
Iron Deficiency Anemia
Vitamin B12 Anemia
What are the Indications for Investigation HbA1c?
Diabetes Therapy
Whether Treatment is Oral Hypoglycaemics, Insulin or a COMBO of Both
What is the Purpose of Investigation HbA1c?
Average Blood Sugar Level
Of the Previous 2/3 MONTHS
Measuring the % of Hb in RBCs that have Glucose attached
How is the Patient Prepared for HbA1c Investigation?
NO Restrictions on
- Food
- Fluids
- Medication
What Specimen is Used for HbA1c Investigation?
Venous Blood WITH Anticoagulant, EDTA
What is the Reference Range of HbA1c?
6% or LESS = Normal
What does the HbA1c Value of OVER 7% Indicate?
Diabetes Control is NOT Good
What is the Hb1Ac Value of Diabetics?
MORE than 6.5%
What is the Hb1Ac Value of Normal People?
LESS than 6%
What does the HbA1c Value of BETWEEN 6 - 6.5% Indicate?
Pre-Diabetes
AT RISK of Diabetes
What is Fructosamine?
End Product of Non-Enzymatic Reaction
BETWEEN Glucose + Amine from Albumin
Aka Glycated Serum Protein
What is the Purpose of Glycated Proteins?
They Determine the AVERAGE Glucose
Over Past 2/3 WEEKS
What is the Indication of Fructosamine Investigation?
Circumstances
Where HbA1c CANNOT be Measured Properly
At What Circumstances is Fructosamine is Investigated, INSTEAD of HbA1c?
- Rapid Change in Diabetes Treatment
- Diabetic Pregnancy
- RBC Loss / Abnormalities
What Specimen Is Used for Fructosamine Investigation?
Serum
What is the Reference Range of Fructosamine?
285 µmol / L
What is the MEAN Reference Range of Fructosamine?
240 µmol / L
What is the Reference Range of Fructosamine, in COMPENSATED DIABETES?
UP-TO 350 µmol / L
What is the Reference Range of Fructosamine, in DECOMPENSATED DIABETES?
OVER 350 µmol / L
What do Normal Fructosamine Levels Indicate?
Not Diabetic
Has Good Diabetic Control
What do HIGH Fructosamine Levels Indicate?
Patient’s Average Glucose over the Last 2/3 WEEKS
HAS ELEVATED
HIGH Fructosamine = HIGH Blood Glucose Levels
What is Microalbuminuria?
Kidney Leaks SMALL AMOUNT of Albumin
INTO Urine
30 - 300mg of Albumin a DAY
What are the Indications of Microalbumin Investigation?
Risk for Developing Kidney Disease
Diabetes
Hypertension
What is the Reference Ranges of Microalbumin?
Normal = UP TO 20 µg / min
OTHERWISE
- 20 -200 µg / min
- 30 - 300 mg / 24h
What Do the Levels of Microalbumin Indicate?
Normal Kidney Function
Otherwise Risk of Developing Kidney Disease
What is C-Peptide?
Pro-Insulin Molecule
Linking alpha + beta chains of insulin
What is the Purpose of C-Peptide?
Monitors Insulin Production
Helps to determine Cause of LOW BGL
What Specimen Is Used for C-Peptide Investigation?
Serum
What are the Reference Ranges for C-Peptide?
Fasting C-Peptide Levels
0.34 – 1.803 nmol / L
What do HIGH C-Peptide Levels Indicate?
HIGH Levels of Endogenous Insulin Production
Insulinoma
Hypokalemia
Renal Failure
What do LOW C-Peptide Levels Indicate?
LOW Levels of Insulin Production
