Clinical biochemistry in diabetes Flashcards
When is glucose checked in diabetes
Self-monitoring of diabetes
When is HbA1c checked in diabetes
Checking glycaemic control
When is the albumin/creatinine urine ratio measured in diabetes
Checking for diabetic renal disease (macrovascular screening)
When is the lipids checked in diabetes
Checking for macrovascular complications
What are the diagnostic tests and values for diabetes
Random venous plasma glucose - greater than or equal to 11.1 mmol/L
Fasting plasma glucose greater than or equal to 7 mmol/L
2 hour plasma glucose - greater than or equal to 11.1 mmol/L
HbA1c greater than or equal to 48 mmol/mol - only for type 2
What is HbA1c diagnostic of
Diabetes - Type 2 only
How is asymptomatic diabetes diagnosed
Atleast two positive tests
How is HbA1c raised in type 2 diabetes
the glucose is not uptaken into cells so it goes into red blood cells and binds to haemeoglobin to form HbA1c which can be measured
When is HbA1c not used for diagnosis
Children and young people
Suspected type 1
Symptoms less than 2 months
pregnancy
if on steroids which cause rapid glucose rise
What are used to measure actute cases in diabetes e.g DKA or hypoglycaemic attack
Urine dip - glycosuria and ketonuria
Glucose meter - measure capillary blood glucose
What is the treatment for DKA
Fluids and insulin
What is factitious hypoglycaemia
They are taking insulin injections so insulin is raised in absence of elevated C peptide
What is an insuloma
Elevated c peptide indicating insulin-secreting tumour
What produces C peptide
It is cleaved off when insulin is produced
