In accordance with the indicated WHO recommendations (Table 4.1), the following fasting plasma glucose levels have diagnostic value:
normalfasting plasma glucose is up to 6.1 (> 110 mg / dL) to 7.0 (> 126 mg / dL) is regarded as a preliminary diagnosis diabetes mellituswhich must be confirmed by repeated determination of blood glucose on other days.
Table 4.1Glucose levels
having diagnostic value.
Glucose concentration in mmol / L (mg / dL)
2 hours after glucose load or two indicators
Impaired glucose tolerance
fasting (if determined)
6.7 (> 120) and 7.8 (> 140) and 7.8 (> 140) and 8.9 (> 160) and
НЬА1с (DCCT standardization in%)
In young children, the normal level of glycated hemoglobin can be achieved at the cost of serious hypoglycemic conditions, therefore, in extreme cases, it is considered acceptable:
blood level HbA1c up to 8.8-9.0%,
the content of glucose in the urine 0 - 0.05% during the day,
lack of severe hypoglycemia,
normal rates of physical and sexual development.
Mandatory laboratory research methods in patients with diabetes mellitus type 2:
General blood test (in case of deviation from the norm, the study is repeated once in 10 days),
Blood biochemistry: bilirubin, cholesterol, triglycerides, total protein, ketone bodies, ALT, ACT, K, Ca, P, Na, urea, creatinine (in case of deviation from the norm, the study is repeated as necessary)
Glycemic profile (determination of fasting blood glucose, 1.5-2 hours after breakfast, before lunch, 1.5-2 hours after lunch, before dinner, 1.5-2 hours after dinner, at 3 am 2-3 times a week),
Urinalysis with the determination of glucose, and if necessary - the determination of acetone.
The criteria for compensation of carbohydrate and lipid metabolism in patients with type 2 diabetes are presented in Table. 4.3. and 4.4.
Table 4.3.Criteria for compensation of carbohydrate metabolism
in patients with type 2 diabetes
What tests need to pass?
- blood glucose
- glycated hemoglobin,
- complete blood count (KLA),
- blood chemistry,
- urinalysis (OAM),
- determination of microalbumin in the urine.
In parallel with this, it is required to periodically complete a complete diagnosis, which includes:
- kidney ultrasound,
- ophthalmologic examination
- Doppler vein and lower limb arteries.
These studies help to identify not only, but also the development of characteristic complications, such as varicose veins, reduced frequency of vision, renal failure, etc.
This blood test for diabetes is very important. Thanks to him, you can monitor the level of glucose in the blood and the pancreas. This analysis is carried out in 2 stages. The first is on an empty stomach. It makes it possible to identify the development of such a syndrome as the “morning dawn”, which is characterized by a sharp increase in the concentration of glucose in the blood in the region of 4–7 o'clock in the morning.
But in order to get more reliable results, the second stage of the analysis is carried out - the blood is re-administered after 2 hours. The indicators of this study allow to monitor the absorption of food and glucose splitting by the body.
These blood tests diabetics need to be done every day. You do not need to run to the clinic every morning. It is enough just to purchase a special blood glucose meter that will allow you to carry out these tests without leaving your home.
The short name is HbA1c. This analysis is carried out in laboratory conditions and is given 2 times a year, provided that the patient does not receive insulin, and 4 times a year while undergoing treatment with insulin injections.
Important! Analysis of the determination of glycated hemoglobin does not provide information on how actively the processes of raising and lowering blood sugar occur. It can only show the average glucose level in the last 3 months. Therefore, it is so important to monitor these indicators on a daily basis with a glucometer.
Venous blood is taken as the biological material for this study. The results that he shows, diabetics need to be recorded in your diary.
In case of type 1 or 2 diabetes, it is recommended to take this analysis every 3 weeks. Its correct decoding allows you to track the effectiveness of the treatment and the development of complications on the background of diabetes mellitus. The analysis is performed in laboratory conditions and blood is taken from a vein on an empty stomach for examination.
Important! If a diabetic has revealed significant deviations from the norm in the course of this study, then additional diagnostics are required to identify pathologies and appropriate treatment is prescribed.
Complete blood count allows you to explore the quantitative indicators of blood components, so you can identify various pathological processes occurring at the moment in the body. To study the blood is taken from the finger. With type 1 or type 2 diabetes, biological material is collected on an empty stomach or immediately after a meal.
With the help of the KLA you can monitor the following indicators:
- Hemoglobin. When this indicator is below normal, this may indicate the development of iron deficiency anemia, the opening of internal bleeding and a general disruption of the blood formation process. A significant excess of hemoglobin in diabetes mellitus indicates a lack of fluid in the body and its dehydration.
- Platelets. These are red bodies that perform one important function - they are responsible for the level of blood clotting. If their concentration decreases, the blood begins to coagulate poorly, which increases the risk of bleeding to open even with minor injuries. If the level of platelets exceeds the boundaries of the norm, then this already indicates an increased blood clotting and may indicate the development of inflammatory processes in the body. Sometimes an increase in this indicator is a sign of tuberculosis.
- Leukocytes. Are health guards. Their main function is the detection and elimination of alien microorganisms. If, according to the results of the analysis, they exceed the norm, then this indicates the development of inflammatory or infectious processes in the body, and may also signal the development of leukemia. A reduced white blood cell level is usually observed after radiation exposure and indicates a decrease in the body's defenses, which makes a person vulnerable to various infections.
- Hematocrit. Many people often confuse this indicator with the level of red blood cells, but in fact it shows the ratio of plasma and red cells in the blood. If the level of hematocrit rises, then it indicates the development of erythrocytosis, if it decreases, anemia or overhydration.
Rules for men and women
Biochemical diagnostics even reveal the hiding processes in the body. For the study, venous blood is taken on an empty stomach.
Biochemical blood test allows you to track the following indicators:
- Glucose level In the study of venous blood sugar levels in the blood should not exceed 6.1 mmol / l. If this indicator exceeds these values, then we can talk about impaired glucose tolerance.
- Glycated hemoglobin. The level of this indicator can be found out not only by passing HbA1c, but also with the help of this analysis. Biochemical indicators allow to determine the further tactics of treatment. If the level of glycated hemoglobin exceeds 8%, then correction of the treatment is carried out. For people suffering from diabetes, the glycated hemoglobin level below 7.0% is considered the norm.
- Cholesterol. Its concentration in the blood allows you to determine the state of fat metabolism in the body. Elevated cholesterol increases the risk of thrombophlebitis or thrombosis.
- Triglycides. An increase in this indicator is most often observed with the development of insulin-dependent diabetes mellitus, as well as with obesity and concomitant T2DM.
- Lipoproteins. With type 1 diabetes, these rates often remain normal. There may be only minor deviations from the norm, which is not hazardous to health. But with type 2 diabetes, the following picture is observed: low-density lipoproteins are elevated, and high-density lipoproteins are underestimated. In this case, urgent treatment is required. Otherwise, serious health problems may occur.
- Insulin Its level allows you to monitor the amount of your own hormone in the blood. In type 1 diabetes, this indicator is always below the norm, and in type 2 diabetes it remains within the normal range or slightly exceeds it.
- C-peptide. A very important indicator that allows you to assess the functionality of the pancreas. With diabetes mellitus 1, this indicator is also at the lower limits of the norm or is equal to zero. In diabetes mellitus, the level of C-peptides in the blood, as a rule, is normal.
- Pancreatic peptide. When diabetes is often undervalued. Its main functions are to control juice production by the pancreas for splitting food.
Biochemical blood test for diabetes need to pass at least 1 time in 6 months
To obtain a more accurate assessment of the health status of a diabetic, blood and urine tests should be taken simultaneously. OAM is dealt with 1 time in 6 months and as UAC allows to reveal various hidden processes in the body.
This analysis allows you to evaluate:
- the physical properties of urine, its acidity, transparency, the presence of sediment, etc.,
- chemical properties of urine,
- the proportion of urine, through which you can determine the condition of the kidneys,
- levels of protein, glucose and ketones.
Any abnormalities in diabetes mellitus require additional examination of the patient. And often for this purpose, an analysis is also taken to determine microalbuminaria.
Determination of microalbumin in the urine
This analysis allows to identify pathological processes in the kidneys in early development. It seems to be this way: in the morning, the person empties the bladder, as usual, and 3 subsequent urine samples are collected in a special container.
If the kidney function is normal, microalbumin is not detected at all in the urine. If there are already any renal impairment, its level rises significantly. And if it is in the range of 3-300 mg / day, this indicates a serious disturbance in the body and the need for urgent treatment.
It is necessary to understand that diabetes is a disease that can disable the whole body and monitor its progress is very important. Therefore, do not neglect the delivery of laboratory tests. This is the only way to keep this disease under control.
Glucose, sugar, diabetes. There is no person in nature who would not know these words. Everyone is afraid of diabetes, so a blood test "for sugar", as a rule, is often and willingly donated. Dr. Anton Rodionov deciphers blood tests, which are diagnosed with diabetes mellitus, tells what is prediabetes and what should be followed in diabetes.
Indeed, along with cholesterol, blood for sugar can and should be donated “just in case” even to children. Do not think that diabetes is a disease of adults. In adolescents with obesity, type 2 diabetes is detected quite regularly - it is a pay-off per day sitting at a computer with chips and Coca-Cola, for sandwiches on the run.
But the most important and most unpleasant thing is that type 2 diabetes in the opening has no symptoms. In the first months, and sometimes the years of the disease, while the sugar level is not overwhelming, the patient will have neither thirst, no frequent urination, no visual impairment, but the disease is already beginning to destroy tissue.
So we got a blood test. Normal fasting glucose is no higher than 5.6 mmol / l. The threshold value for the diagnosis of diabetes mellitus is from 7.0 mmol / l and higher. And what between them?
* Standards are given for plasma glucose obtained by taking blood from a vein.
This "gray zone" (prediabetes) is very insidious. In medical language, it is called “impaired fasting glucose”. This is not the norm and not the "upper limit of the norm." This is pre-disease, which requires treatment, however, is not always medicinal.
In an amicable way, if the glucose level is within 5.6–6.9 mmol / l, the doctor should offer the so-called glucose tolerance test (or glucose tolerance test). You will be given a drink of 75 mg of glucose dissolved in a glass of water, and they will look at blood sugar in 2 hours.
If 120 minutes after the carbohydrate load, the glucose level remains above 11.0 mmol / l, then the diagnosis of diabetes mellitus is established. But even if the glucose level is below this value, in the range of 7.8–11.0 mmol / l, a diagnosis of impaired glucose tolerance is made.
The treatment of this condition consists in a serious review of your diet, restriction of high-calorie and high-carbohydrate foods and weight loss. Often, at the level of prediabetes, the doctor prescribes metformin - it not only reduces blood glucose, but also helps to lose weight.
Important detail: the diagnosis must be repeated twice to establish the diagnosis . This eliminates the so-called "stress hyperglycemia", when glucose rises as a reaction to stress caused by an acute illness or simply by visiting a medical institution.
If you have prediabetes (fasting blood glucose 5.6–6.9 mmol / l), this is a reason for at least a serious lifestyle change, and sometimes the start of drug therapy. If you do not do anything, then diabetes will not take long.
Products that can be used without restriction: all vegetables, except potatoes (it is advisable to cook, not fry), as well as tea, coffee without cream and sugar.
Foods that can be consumed in moderation (eat twice less than usual): bread, cereals, fruits, eggs, lean meat, lean fish, low-fat dairy products, cheese less than 30% fat, potatoes, corn.
Foods that should be excluded from the daily diet:
- foods high in fat: butter, fatty meats, fish, smoked meats, sausage, canned goods, cheese with fat content> 30%, cream, sour cream, mayonnaise, nuts, sunflower seeds,
- sugar, as well as pastries, sweets, chocolate, jam, jam, honey, sweet drinks, ice cream,
And a few more uncomplicated rules that will be useful to those who have elevated glucose levels:
- Eat raw vegetables and fruits, adding butter and sour cream to a salad increases their caloric content.
- Choose low fat foods. This applies to yogurt, cheese, cottage cheese.
- Try not to fry foods, but to cook them, bake or stew them. Such treatments require less oil, which means that the caloric content will be lower.
- "If you want to eat, eat an apple. If you don't want an apple, you do not want to eat." Avoid snacking with sandwiches, chips, nuts, etc.
Diabetes: what tests to take
Let's return to our analyzes. Blood sugar with a double measurement> 7.0 mmol / l is already diabetes. In this situation, the main mistake is an attempt to undergo treatment without medication and “dieting”.
No, dear friends, if the diagnosis is established, then drug treatment should be prescribed immediately. As a rule, they start with the same metformin, and then add drugs from other groups. Of course, drug treatment of diabetes does not completely eliminate the need to lose weight and revise your diet.
If you have an increase in glucose at least once, be sure to buy a blood glucose meter and measure sugar at home, so you can diagnose diabetes earlier.
Disorders of carbohydrate metabolism are often accompanied by an increase in cholesterol and triglycerides (and by the way, hypertension), so if diabetes or even prediabetes is found, be sure to have a blood test for lipid profile and monitor blood pressure.
Glucose in the blood changes every minute, it is a rather unstable indicator, but glycated hemoglobin (on a laboratory form it is sometimes referred to as "glycosylated hemoglobin" or abbreviated HbA1C) is an indicator of long-term compensation of carbohydrate metabolism.
As is known, an excess of glucose in the body damages almost all organs and tissues, especially the circulatory and nervous system, but it does not bypass the blood cells. So, glycated hemoglobin (it is expressed as a percentage) is translated into Russian as the share of "candied red blood cells."
The higher the rate, the worse. In a healthy person, the proportion of glycated hemoglobin should not exceed 6.5%; in patients with diabetes mellitus receiving treatment, this target value is calculated individually, but is always in the range of 6.5 to 7.5%, and when planning pregnancy and pregnancy time requirements for this indicator even stricter: it should not exceed 6.0%.
With diabetes mellitus, the kidneys are often affected, so laboratory monitoring of the kidneys is very important for diabetics. This is for microalbuminuria.
If a renal filter is damaged, glucose, protein and other substances that normally do not pass through the filter begin to enter the urine. So microalbumin (small albumin) is the lowest molecular weight protein that is detected in the urine first. Those who suffer from diabetes should take a urine test for microalbuminuria every six months.
I was surprised to learn recently that in some places diabetics determine sugar in the urine. This is not necessary. It has long been known that the renal threshold for glucose in urine is very individual and it is absolutely impossible to focus on it. In the 21st century, only blood tests for glucose and glycated hemoglobin are used to diagnose and evaluate diabetes compensation.
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Comment on the article "Blood for sugar: norm, diabetes and prediabetes. Deciphering the analysis"
Diabetes 14? This does not affect the appearance. and often the person himself does not even feel anything. Diabetes is not some kind of diathesis, people really can have a coma.
What is diabetes? Diabetes mellitus is a chronic disease, in which there are two, for often passing years before the first symptoms of diabetes manifest.
I am 33 years old, diabetes was diagnosed 9 months ago, on pills, type 2, but there are advances to type-1 (I tried to give birth to a relative in 20 years, diabetes from 5 years old, on insulin. At 26th week.
A relative tried to give birth at 20, diabetes from the age of 5, on insulin. on the 26th week severe bleeding began - something happened to the uterus vessels. the child was not saved, it was barely pumped out, though it was more than 10 years ago. the whole pregnancy lay in the hospitals, in the movie such pregnancies were conducted.
Diabetes and hypertension are the first symptoms: pressure and sugar standards. Diabetes and pregnancy. Determine blood sugar should be at the beginning of pregnancy weekly, and to.
It was like a friend. Predicted diabetes in a child. A healthy boy was born. After birth, sugar and he and mom's normal.
@@ email protected @ email protected @ email protected @ email protected @ email protected @ email protected @ email protected
with diabetes you can give birth to a healthy baby. however, the sooner the better and only with the proper observation of such a pregnancy. and even more, you can adopt.
with diabetes you can give birth to a healthy baby. however, the sooner the better and only with the proper observation of such a pregnancy. and even more, you can adopt. There is no diabetes per se in the list of diseases.
There is a list of diseases that prevent the possibility of being an adoptive parent. Diabetes is not there. There is a disability that eliminates performance, as you are told below. There is also a point “chronic diseases in the stage of decompensation” - the district clinic can “catch on” for this item. So if a friend works, it’s necessary that she first go to her endocrinologist just in case, so that he can write to the map that her disease is compensated (or sub-compensated). After that, with a map and all other seals in medical reference, to the therapist. And there a friend should clearly explain, showing perseverance that she knows the laws, that diabetes is not on the list, and so on. I managed. Although it was troublesome - they didn’t really want to give help. If you have questions - write to the diary - I have experienced all this the hard way. And I have the exact same diagnosis.
Signs of diabetes. Diagnosis. Medicine and health. Diseases, symptoms and their treatment: tests, diagnosis, doctor, drugs, health.
Sugar in the urine appears only after the renal threshold has been exceeded in the blood. So if you suspect diabetes, then it is better to go and donate blood for sugar.
Sugar in the urine appears only after the renal threshold has been exceeded in the blood. So if you suspect diabetes, then it is better to go and donate blood for sugar. Buying a blood glucose meter for the sake of one analysis is painful. Or find familiar diabetics, let them check your child with their device.
We use Wrygluk. Normally determined. We still have test strips for the determination of ketones, protein, Ph. By the way, in order for glucose to appear in the urine, it is necessary for the blood sugar to go off scale. Those. not only exceeded the norm, but also exceeded the so-called. "kidney threshold" (in children it is somewhere 8-9 mmol / l in the blood). IMHO, it is enough to donate blood for sugar to accurately determine whether test strips are necessary. Well this is money thrown away if there is no diabetes. :)
I checked a child a million times - the result is always negative. And myself too. This is my husband enjoys. And then in his normal course of diabetes in the urine, very rarely is he elevated.
Anya, what caused this desire?
One can think about diabetes when an empty stomach (after an 8-hour gliding) blood glucose is more than 7 mmol / l and such indicators are repeated several times. Why do you think your daughter.
The absence of glucose in the urine does not yet indicate the absence of diabetes, since with healthy kidneys, glucose in the urine appears at blood concentrations higher than 8.8 mmol / l - this is the so-called renal glucose threshold. Ketones appear if glucose is even higher than 13-16 mmol / l. The kidney glucose threshold is different for everyone; it is a little lower in the elderly; in the elderly, even at high glucose levels, it may not appear in the urine.
Blood glucose standards on an empty stomach are 3.3-5.5 mmol / l (or 4.4-6.6 mmol / l - this depends on the method used in the laboratory, the laboratory usually indicates what their norms are). One can think about diabetes when an empty stomach (after an 8-hour gliding) blood glucose is more than 7 mmol / l and such indicators are repeated several times.
Why do you think your daughter has diabetes? What worries you?
Unfortunately, a one-time test may not show the presence or absence of diabetes: O (. You need to watch the dynamics - on an empty stomach, an hour, two after a meal. It is better to check by blood, because ketones in the urine do not appear immediately, but only if for a long time sugar is higher than 13-14 mmol / l. And the best way is to ask this question on www.dia-club.ru, well, and the most optimal, to pass tests in the clinic, because even with visual strips the error in measurements is about 20% , Unfortunately.
It is necessary to play sports, for example, walk or run for half an hour every day. 01.20.2002 01:18:01, happy
Treatment of diabetes without insulin. Diet for diabetes. Normally, the metabolism is as follows. Diabetes and hypertension are the first symptoms: pressure and sugar standards.
Hello, Doctor! We live in Zlatoust, Chelyabinsk region. With good literate narrow specialists, the situation is not very. I would like to consult with another doctor. My son is now 7 years 8 months old. We will be examined by an endocrinologist after having had one episode in January, when after taking a bath he shook very strongly, his arms and legs walked with a walk. I guessed to give him a sweet, warm tea, after that everything went in about a minute or two. Poured blood on sugar on an empty stomach. analysis showed 3.61. The endocrinologist suggested another sugar curve with a glucose load of 33 grams per cup of water (weight 19 kg). Results: 3-66 - 11.33 - 10.67 - 6.40. Analysis of daily urine sugar negative, beats. weight 1018 (she counted daily diuresis on this day: 1200 was drunk, 900 were allocated). Fasting blood test for insulin: 1.6 μED / ml. Passed on another C-peptide, waiting for the result. We have not gone to the reception yet, as with coupons we are waiting for our turn. We also made a clinical advanced blood test at the same time, if necessary, I will write the results, there are some deviations from the reference values. I beg you, please write what you think about our results.
03/19/2019 08:29:04, Galina Donskikh
Blood test for sugar. norms - 3,33-5,55 mmol liter. But the concept of "NORM" insulin is not (this lek. Drug), the dose is selected for each child purely individually. Transient hyperglycemia is permissible during certain periods of the day., Up to 6.0 mmol / liter.
12/23/2000 12:38:08 Vladimir
Diabetes is an insidious disease, precisely because it may be asymptomatic. Its signs may be present, but it does not alarm the person.
Phenomena such as increased thirst, increased urine output, constant fatigue and increased appetite can be symptoms of many other pathologies in the body, or simply temporary problems.
And not every person can experience all the symptoms - someone may experience only one of them, and he may not attach much importance to this.
Therefore, in such a matter as the diagnosis of diabetes, tests - the most reliable and truthful way. There is nothing difficult in their surrender, it is enough to consult a doctor, and he will already determine what exactly you need.
What are the tests
Usually for research or take blood or urine. The type is already prescribed by the doctor himself. Treatment time and regularity play a major role in the issue of diabetes testing. The sooner and more often (the latter - with a predisposition to the disease) - the better.
There are some types of research:
- With the help of a glucometer. It is conducted not in the laboratory, and you can do it, being at home and not being a specialist in medicine. Blood glucose meter - an apparatus that shows the level of glucose in the blood of a person. He must be present in the house of a diabetic, and if you suspect a disease, the first thing you will be asked is to use a blood glucose meter.
- Glucose test. It is also called a test for glucose tolerance. This method is perfect not only to identify the disease itself, but also the presence of a condition close to it - prediabetes. Blood will be taken from it for you, then 75 g of glucose will be given to drink, and after 2 hours it is required to donate blood again. The results of this study can be influenced by various factors, from physical exertion to dishes that a person consumed,
- On the C-peptide. This substance is a protein, if it is present in the body, it means that insulin is produced. Often taken together with blood for glucose, and also helps to determine the pre-diabetic state,
- General analysis of blood and urine. They are handed over whenever they undergo any medical examinations. By the number of blood bodies, platelets and white blood cells, doctors determine the presence of hidden diseases and infections. For example, if there are not enough white bodies, it indicates the presence of problems with the pancreas - it means that sugar can increase in the near future. It can be detected in the urine,
- On whey ferritin. Few people know that a surplus of iron in the body may be the cause of insulin resistance (immunity).
If there are concomitant diseases, or you have already identified diabetes, other tests may be prescribed - for example, in case of hypertension, blood is tested for the presence of magnesium in it.
More about blood tests
Which analysis is the most accurate
Theoretically, all the studies that are conducted in the laboratory, show the true result - but there are methods by which you can determine the disease is almost unmistakable. The simplest, most affordable, and painless measurement is a glucometer.
Diabetes doctors learned how to treat many years ago. Therapy is to normalize the level of sugar and maintain it throughout life. This should be done independently, but under the supervision of the attending physician. Diabetes tests are an important element of this therapy. They allow you to find out the rate of development of the disease, and the presence of complications, as well as the feasibility of applying new methods of treatment.
Of course, the deterioration can be seen and so. Usually, with increased sugar, the skin begins to itch, the patient is very thirsty, and has frequent urination. But sometimes the disease can proceed covertly, and then it can only be determined with an appropriate analysis.
In tests for diabetes is very important to observe regularity. Then you can know the following:
- whether the beta cells of the pancreas are completely damaged or can their activity be restored,
- how successful are therapeutic interventions
- Do the complications of diabetes develop and at what pace
- how high is the likelihood of new complications.
There are obligatory tests (for example, complete blood count, determination of blood sugar and urine levels), as well as auxiliary tests, which are best done in order to get more information about the disease. Consider them in more detail.
General blood analysis
A general blood test is performed in order to identify general abnormalities in the body. In diabetes, characteristic indicators may have the following meanings:
- Hemoglobin. Low values indicate developing anemia, internal bleeding, problems with blood formation. Excess hemoglobin indicates severe dehydration.
- Platelets. If these little bodies are very small, it means that the blood will coagulate poorly. This indicates the presence of infectious diseases, inflammatory processes in the body.
- Leukocytes. The increase in the number of white bodies indicates the presence of inflammation, an infectious process. If they are few, the patient may suffer from radiation sickness and other serious pathologies.
Oral glucose tolerance test
When the level of glucose in the plasma of venous blood on an empty stomach is above 15 mmol / l (or with several definitions on an empty stomach above 7.8 mmol / l), the diagnosis of diabetes mellitus is not carried out to establish a diagnosis of diabetes mellitus.
During GTT, the patient should receive regular food for 3 days prior to the study (with a carbohydrate content of more than 150 g per day), and also refrain from eating food the evening before the examination. When conducting GTT, they determine the level of glucose on an empty stomach, and then give to drink 75 g of glucose dissolved in 300 ml of warm water or tea with lemon for 35 minutes (for children, 1.75 g / kg, but not more than 75 g). Re-determine the level of glucose after 2 hours. During the test, the subject is not allowed to smoke. The principles for evaluating GTT are shown in the following table.
|Evaluation option||Norm||Impaired glucose tolerance||Diabetes|
|Fasting blood||up to 5.5 mmol / l||up to 6.7 mmol / l||more than 6.7 mmol / l|
|2 hours after taking||up to 7.8 mmol / l||up to 11.1 mmol / l||more than 11.1 mmol / l|
Intravenous glucose tolerance test
Persons whose glucose load causes nausea or who have gastrointestinal disorders with a suction disorder may perform an intravenous glucose tolerance test.
In this case, after determining the glucose level, a 25% sterile glucose solution is administered at a rate of 0.5 g / kg body weight for 5 minutes on an empty stomach.
Then every 10 minutes for an hour, determine the content of glucose in the blood and calculate the coefficient of glucose assimilation by the formula:
K — 10 / t, where K is a coefficient indicating the rate of glucose disappearance from the blood after intravenous administration, t is the time required to reduce the level of glucose by 2 times compared with the indicator 10 minutes after the introduction of glucose.
Normally, the coefficient K is more than 1.2 - 1.3,
in patients with diabetes below 1.0, and values from 1.0 to 1.2 indicate impaired glucose tolerance.
Prednisolone Glucose Tolerance Test
The test contributes to the identification of hidden disorders of carbohydrate metabolism, since prednisone stimulates glucose processes and suppresses the formation of glycogen.
In combination with glucose load, this leads to more significant glycemia in individuals with functional pancreatic β-cell insufficiency.
To test the patient for 8.5 and 2 hours before the oral GTT give 10 mg of prednisone per os. The level of glucose in the blood is determined on an empty stomach, after 1 hour and 2 hours after loading glucose. The rise of glucose after 1 hour is more than 11.1 mmol / l, after 2 hours more than 7.8 mmol / l indicates a decrease in glucose tolerance. Such patients need additional observation and examination.
Determination of urine glucose
In the urine of a healthy person, glucose is not detected.
Glucosuria is detected when the blood glucose exceeds a certain level of the renal threshold for glucose, which is 8.810 mmol / l. In this case, the amount of glucose filtered into the primary urine exceeds the capacity of the kidneys for reabsorption. With age, the renal threshold for glucose increases, for persons over 50 years it is more than 12 mmol / l.
In patients with diabetes mellitus, the determination of urine glucose is used to assess compensation and control treatment. Glucose is measured in daily urine or in three portions (on an empty stomach, after the main meal and before bedtime). The criterion of compensation in patients with type 2 diabetes mellitus is the achievement of aglucosuria, and in case of type I diabetes, up to 2030 g of glucose per day is allowed.
The state of the vessels can significantly change the renal threshold for glucose, so the absence of glucose in the urine cannot definitively indicate the absence of diabetes mellitus, and glucosuria on its presence.
Biochemical diagnosis of diabetes
The task of laboratory testing in cases of suspected diabetes mellitus is to identify or confirm the patient’s absolute or relative insulin deficiency. The main biochemical signs of insulin deficiency are: fasting hyperglycemia or an increase in glucose after eating beyond the normal limits, and glycosuria and ketonuria. In the presence of clinical symptoms of diabetes, laboratory studies are necessary primarily to confirm the clinical diagnosis. In the absence of symptoms, the results of laboratory tests themselves can establish an accurate diagnosis.
To diagnose diabetes perform the following studies:
* blood test for glucose in capillary blood (blood from a finger).
* glucose tolerance test: about 75 g of glucose dissolved in a glass of water are taken on an empty stomach, then the concentration of glucose in the blood is determined every 30 minutes for 2 hours.
* urine analysis for glucose and ketone bodies: the detection of ketone bodies and glucose confirms the diagnosis of diabetes.
* determination of glycated hemoglobin: its amount is significantly increased in patients with diabetes mellitus.
* determination of insulin and C-peptide in the blood: in the first type of diabetes mellitus, the amount of insulin and C-peptide is significantly reduced, while in the second type, values are within the normal range.
Biochemical study of blood glucose
Methodological features of the determination of glucose in the blood:
- Currently existing portable blood glucose meters (using test strips) cannot provide accurate measurement of glucose concentration with sufficient analytical reliability, so they should not be used for the diagnosis of diabetes mellitus. The concentration of glucose in the blood must be investigated in a licensed CFL.
- KDL should use methods for analyzing the glucose concentration in the blood, which have an analytical variation of not more than 3.3% (0.23 mmol / l from 7.0 mmol / l), and the total inaccuracy should be below 7.9%.
Reductometric methods for determining blood sugar, based on the ability of sugars, in particular glucose, to reduce heavy metal salts in an alkaline medium. There are various reactions. One of them is to restore the red blood salt to the yellow blood salt sugar, boiled and alkaline. After this reaction, the sugar content is determined by titration.
Colorimetric methods for determining (sugar) in the blood: glucose is able to react with various compounds, resulting in the formation of new substances of a certain color. According to the degree of color of the solution using a special device (photocolorimeter) judge the concentration of glucose in the blood. An example of such a reaction is the Samoji method.
Samples analyzed: non-hemolyzed serum or blood plasma, which is obtained in the usual way. To determine glucose in whole blood, 2 tablets of an anticoagulant should be dissolved in 100 ml of distilled water.
Equipment: spectrophotometer or photoelectric colorimeter, wavelength 500 (490-540) nm, a cuvette with an optical path length of 10 mm, automatic or semi-automatic biochemical analyzers.
Determination of glucose concentration in blood (plasma, serum)
The principle of the method: during oxidation of α-D-glucose with atmospheric oxygen with the catalytic action of glucose oxidase, an equimolar amount of hydrogen peroxide is formed. Under the action of peroxidase, hydrogen peroxide oxidizes 4-aminoantipyrine in the presence of phenolic compounds into a colored compound, the color intensity of which is proportional to the glucose concentration in the analyzed sample and is measured photometrically at a wavelength of 500 (490-540) nm.
Preparation for analysis. Preparation of the working reagent: place 2 tablets of the buffer substrate in a 200 ml measuring flask, add 500 ml of distilled water, mix thoroughly until complete dissolution of the tablets, dissolve the Enzymes tablet in 5.0 ml of distilled water, transfer quantitatively to the flask with the solution - substrate mixture, bring to the mark with distilled water and mix thoroughly. Transfer the working reagent to dark glassware.
Add the test samples of serum or plasma and reagents according to the following scheme:
General urine analysis
Even if you constantly monitor the level of glucose in the blood, it is necessary to take a urine test once every six months. It allows you to find out whether the kidney diabetes is affected. The analysis shows the following:
- the presence of sugar in the urine,
- various chemical indicators
- physical properties of urine,
- specific gravity,
- the presence of acetone, proteins and other substances in the urine.
Although the general analysis of urine does not give a complete picture of the disease, it allows you to find out some of its details.
Microalbumin in the urine
This analysis is necessary in order to identify early kidney damage in diabetes mellitus. In a healthy state, albumin is not excreted through the kidneys, and therefore is not present in the urine. If the kidneys cease to function normally, the albumin in the urine increases. This indicates a developing diabetic nephropathy, as well as disorders of the cardiovascular system.
This protein appears in the pancreas during the breakdown of primary insulin. If it circulates in the blood, it indicates that the gland still produces this hormone. If the amount of this substance is normal, and the sugar in the body is elevated, it is, that is, type 2 diabetes. Then they begin to follow a low-carb diet, take hypoglycemic drugs and drugs that fight insulin resistance.
A significant increase in C-peptide is indicative of advanced type 2 diabetes, and its amount below the norm indicates the need for insulin treatment. It is recommended not to begin treatment for diabetes without finding out the amount of your C-peptide. Then this analysis can not be carried out, but the initial clarification of the situation will greatly help to prescribe the correct therapy.
There are other laboratory tests to determine the characteristics of the course of diabetes. In particular, these are tests for iron, for thyroid hormones, and for cholesterol. All of them allow you to identify comorbidities and possible complications, but not required for each patient. They can recommend a doctor if there is a need for this.
Diagnostic procedures for diabetes.
As already mentioned, diabetes causes multiple changes in the body and leads to serious consequences. In order to detect complications in time, it is not enough to pass tests. You must still go to the diagnostic procedures listed below.
Most often, diabetes mellitus eventually affects the kidneys, causing renal failure. In many patients, it reaches such an extent that transplantation is required. Ultrasound allows you to identify changes in the structure of the body. Examination should be regular in order to detect pathology in time and prevent further development of the disease.
Examination of the fundus
Another favorite area for diabetes is eye tissue. When an excess amount of sugar in the blood manifests itself, since the fragility of small blood vessels increases, hemorrhages become more frequent, which leads to a change in the fundus of the eye. In the future, the patient's eyesight deteriorates, glaucoma and cataracts develop. Constant examination by an ophthalmologist will make it possible to detect this process in the early stages and save eyesight.
Doppler ultrasound of limb vessels
Diabetes affects the blood vessels not only of the eye, but throughout the body, in particular, of the extremities. Point hemorrhages, spasms, gluing of small arteries - all this leads to the death of blood vessels and the onset of tissue necrosis. In order to prevent the possible development of gangrene, it is recommended to regularly monitor the condition of the vessels and promptly begin treatment. In addition, you must have a personal and take measurements of sugar every day.
The most important tests for diabetics
Any diagnostic procedure has a certain value, because it provides additional information about the disease or its complications. But there are the most important analyzes. These include constant monitoring of blood sugar with a glucometer, regular monitoring of sugar in the urine. Other tests should be carried out periodically, but only with the agreement of your doctor.
A patient with diabetes mellitus must first learn to maintain glucose levels in normal conditions. Then you can avoid the pathologies of the kidneys, eyes, limbs, etc. To do this, you need not only to take measurements with a glucometer, but also to follow a low carbohydrate diet and take drugs in a timely manner.
The analysis of glycated hemoglobin allows you to find out how well the sugar level is maintained over a long period. In other words, this analysis shows the average glucose level for 3 months. This is especially important if the children suffer from the disease, who may not follow the diet, and put their blood in order before the tests. This analysis will be able to detect this tricky move and show the real picture.
The second most important analysis of the optional - C-reactive protein. It is quite cheap, but allows you to identify the state of the pancreas and choose the right treatment. Other tests are desirable for delivery, but they are expensive and will only show some details of the disease. In particular, lipid analysis can show how much fat is circulated in the body, cholesterol, and how it affects the blood vessels.
An analysis of thyroid hormones will help identify the pathology of this organ and eliminate it. After all, failures in the thyroid gland greatly affect the course of diabetes. The endocrinologist will be able to determine the pathology and prescribe treatment. After a course of drugs, it is necessary to repeat the test and evaluate the change. But if the financial situation does not allow such regular surveys, it is better to abandon them, rather than control over the level of sugar.
- laboratory analysis, which shows the level of glucose in the blood. Increasing glucose means that a person needs a thorough examination regarding the presence of diabetes.
What are the manifestations of diabetes?
Depending on the type of disease, the symptoms can be either pronounced or blurred.
Diabetes of the first type is characterized by an acute onset of the disease at a young age, accompanied by a sharp decrease in weight in the absence of dietary restrictions.
Among patients with diabetes of the second type, older people (from 40-45 years old) predominate, in most cases being overweight. The development of this form of diabetes is not accompanied by weight loss - on the contrary, patients are gradually gaining extra pounds in addition to those that already exist.
Despite the different causes and nature of the disorders in diabetes of the first and second type, there are signs that are characteristic of both forms. First of all, it is growing thirst, forcing to drink much more water than before the disease. Due to excess water intake, the disease is accompanied by polyuria - abundant and frequent urination. In addition, patients may complain of a feeling of obsessive pruritus, poorly healing ulcers, wounds and ulcers of the skin.
What do analysis numbers mean?
Blood for diabetes shows the level of fasting glucose in it. The normal value of the indicator is from 3.3 to 6.1 mmol / l from venous blood plasma. Glucose above 7.0 mmol / l means that the person is sick with diabetes. Intermediate values from 6.1 to 7.0 mmol / l indicate the presence of prediabetes.
Another option for determining blood glucose is the glucose tolerance test, which shows how efficiently the body utilizes glucose from food. The test is to measure the glucose level after a carbohydrate load in the form of a sweet drink. A value above 7.7 mmol / l two hours after consuming the sweet solution indicates a violation of glucose uptake.
If blood for diabetes shows an elevated glucose level, another test should be taken - the level of glycated hemoglobin, expressed as a percentage of the total hemoglobin. This analysis shows how many compounds of erythrocytes with glucose are in the blood. Increasing the level of glycated hemoglobin means that a person has had a steady increase in blood sugar levels over the past three months. Normal values of the indicator are set within 6% of the total mass of hemoglobin.
Why take a blood test for biochemistry for diabetes?
In diabetes mellitus, a biochemical blood test is of particular importance:
- glucose control,
- assessment of changes in glycated hemoglobin (in percent),
- determining the amount of C-peptide,
- assessment of lipoproteins, triglycerides and cholesterol,
- evaluation of other indicators:
- total protein
- enzymes ALT and AST,
All of these indicators are important for controlling the disease. Even small deviations may indicate a change in the patient’s condition. In this case, you may need to change the course of treatment.
Decoding of blood biochemistry in diabetes mellitus
Each indicator in the biochemical analysis of blood is of particular importance for diabetics:
Blood biochemistry is an important control element in diabetes mellitus. Each indicator is important, allows you to monitor the normal functioning of the internal organs and in time to diagnose abnormalities in the work of individual body systems.
Determination of glycosylated hemoglobin
Hyperglycemia in diabetes mellitus leads to non-enzymatic glycosylation of erythrocyte hemoglobin. This process occurs spontaneously and is normal throughout the life of red blood cells, but with increasing glucose concentration in the blood the reaction rate increases. In the initial stage, the glucose residue is attached to the N-terminal residue of the valine β-chain of hemoglobin, forming an unstable compound aldimine.
With a decrease in glucose and blood, the aldimine disintegrates, and with persistent hyperglycemia, it is isomerized into stable, durable ketimine and circulates in this form the entire period of the erythrocyte's life, i.e. 100 - 120 days. Thus, the level of glycated hemoglobin (HbAlc) is directly dependent on the level of blood glucose.
The red blood cells circulating in the blood have different ages, therefore, for the average characteristic, they are oriented on the half-life of red blood cells for 60 days. Consequently, glycated hemoglobin shows what the glucose concentration was in the previous 48 weeks prior to the examination and is an indicator of the compensation of carbohydrate metabolism during this time.
According to the WHO recommendation (2002), HbAlc is determined in the blood of patients with diabetes mellitus 1 time in 3 months.
A normal glycosylated hemoglobin value is considered to be 46% of the total hemoglobin level.
|Compensation level||Type of diabetes|
|Compensated||6,0 — 7,0||6 — 6,5|
|Subcompensated||7,1 7,5||6,6 7,0|
|Decompensated||more than 7.5||more than 7.0|
Increased glycated hemoglobin also indicates an increased risk of developing complications of diabetes. A false increase in HbAlc may be associated with a high concentration of fetal hemoglobin (HbF), as well as with uremia. The causes of a false decrease in HbAlc are hemolytic anemia, acute and chronic hemorrhages, blood transfusions.
Compared with the determination of glucose level, this method does not depend on the time of day, physical exertion, food intake, prescribed medications, and emotional state.
The assessment of the safety of insulin products is carried out by the level of immunoreactive insulin and C-peptide.
The normal fasting serum insulin is 624 MCU / L (29181 mmol / L).
Normally, the level of the hormone in the blood increases dramatically after a meal, since carbohydrates are the main regulator of hormone secretion from the pancreas.
This reaction allows you to use the test for the differential diagnosis of diabetes mellitus type 1 and II, with parallel determination with GTT.
In individuals with type 1 diabetes mellitus, the basal insulin level is reduced, there is no pronounced reaction to food intake. In diabetes mellitus type II, the basal level of insulin is normal or elevated, and its response to an increase in blood glucose is slow.
However, the use of this test is possible only in patients who have not received or have not previously received insulin preparations, since antibodies are formed to exogenous insulin that distort the results of the study.
Therefore, the most common definition of immunoreactive insulin is carried out for the diagnosis of insulin and the differential diagnosis of hypoglycemic states.
C-peptide fragment of proinsulin molecule, cleaved during the formation of active insulin. It is excreted into the bloodstream in almost equal to insulin concentrations. Unlike insulin, C-peptide is biologically inactive and is metabolized in the liver several times slower. Therefore, the ratio of C-peptide and insulin in peripheral blood is 5: 1. When using IFAmethod, the Species does not give an overlap reaction with insulin and therefore makes it possible to evaluate insulin secretion even when receiving exogenous insulin, as well as in the presence of autoantibodies to insulin.
The normal concentration of C-peptide is 4.0 µg / L.
After oral glucose loading, a 56-fold increase in C-peptide is noted.
The end product of anaerobic glycolysis. Its content is normally significantly different in various biological fluids: arterial blood 0.33 - 0.78 mmol / l, venous blood 0.56 - 1.67 mmol / l, cerebral spinal fluid 0.84 - 2.36 mmol / l
Lactic acid is also detected in gastric cancer in the gastric juice, although it is normally absent there.
Methods of laboratory diagnosis of diabetes
To date, many methods have been developed to identify diabetes in the laboratory. They can be conducted for various purposes, for example, to diagnose the disease at an early stage, determine the type of diabetes and identify possible complications.
When conducting laboratory tests for diabetes mellitus, a patient is usually taken a blood and urine sample for analysis. It is the study of these physiological fluids that helps to identify diabetes in the very early stages, when other signs of the disease are not yet available.
Methods of diagnosis of diabetes are divided into basic and additional. The main methods of research include:
- Blood Sugar Test
- Diagnosis on the amount of glycated hemoglobin,
- Study on glucose tolerance,
- Analysis for the presence of sugar in the urine,
- The study of urine and blood for the presence of ketone bodies and their concentration,
- Diagnosis of fructosamine level.
Additional diagnostic methods that are needed to clarify the diagnosis:
- A study on insulin levels in the blood,
- Analysis of autoantibodies to insulin-producing beta cells of the pancreas,
- Diagnosis of proinsulin,
- Ghrelin, adiponectin, leptin, resistin,
- Research on IIS-peptide
- HLA typing.
To pass these analyzes, you must receive a referral from an endocrinologist. He will help the patient to determine which type of diagnosis he needs to undergo, and after receiving the results he will select the most appropriate treatment method.
Great importance for obtaining an objective result is the correct passage of the tests. To do this, you should strictly follow all the recommendations on preparing for diagnosis. This is especially important when a patient is diagnosed with diabetes mellitus, since these research methods are very sensitive to the slightest violation of the preparation conditions.
Blood Sugar Test
Laboratory diagnosis of diabetes should begin with a blood test for glucose levels. There are several methods for passing this analysis. The first and most common is fasting blood and the second two hours after meals. The first method is the most informative, therefore, when making a diagnosis, endocrinologists most often write out a referral specifically for this type of diagnosis.
Before passing the analysis it is necessary:
- Do not drink alcoholic beverages 24 hours before the diagnosis,
- Last time to eat food no later than 8 hours before the analysis,
- Drink only water before analysis.
- Do not brush your teeth before donating blood, as sugar may be part of the toothpaste, which tends to be absorbed through the mucous membrane of the mouth. For the same reason, chewing gum should not be chewed.
This analysis is best done in the morning before breakfast. Blood for him is taken from the finger. In rare cases, venous blood may be required to determine the level of sugar.
The normal blood sugar level for an adult is from 3.2 to 5.5 mmol / l. An indicator of glucose in the body above 6.1 mmol / l indicates a serious violation of carbohydrate metabolism and the possible development of diabetes.
Glycosylated Hemoglobin Assay
This diagnostic research method is most important for detecting diabetes in the early stages. The accuracy of HbA1C analysis is superior to any other types of research, including a blood test for sugar.
Diagnosis of glycated hemoglobin allows you to determine the level of sugar in the blood of the patient over a long period of time, up to 3 months. While the sugar test gives an idea of the level of glucose in the blood only at the time of the study.
The analysis for glycated hemoglobin does not require special preparation from the patient. It can be taken at any time of the day, on a full and hungry stomach. The result of this test is not affected by the intake of any medications (with the exception of sugar-reducing tablets) and the presence of colds or infectious diseases in the patient.
The HbA1C test determines how much hemoglobin in the patient's blood is associated with glucose. The result of this analysis is reflected in percentages.
The results of the analysis and its value:
- Up to 5.7% is the norm. There are no signs of diabetes,
- From 5.7% to 6.0% - predisposition. This indicates that the patient has a disorder in carbohydrate metabolism,
- From 6.1 to 6.4 - prediabetes. The patient should immediately take measures, it is especially important to change the diet.
- Over 6.4 - diabetes. Conduct additional tests to determine the type of diabetes.
Among the disadvantages of this test can be noted its high cost and availability only for residents of large cities. In addition, this analysis is not suitable for people with anemia, as in this case, its results will be erroneous.
Analysis of glucose tolerance
This test is key to detecting type 2 diabetes. It helps determine the rate of insulin secretion, as well as determine how sensitive the patient’s internal tissues are to this hormone. For the analysis of glucose tolerance, only venous blood is used.
In order for the test results to be the most accurate, the patient should completely abandon the meal 12 hours before the start of the diagnosis. The test itself is carried out as follows:
- First, a fasting blood test is taken from the patient and the initial sugar level is measured,
- Then the patient is allowed to eat 75 grams. glucose (less often 50 grams and 100 grams) and after 30 minutes, the blood sugar level is again measured,
- Then this procedure is repeated three more times - after 60, 90 and 120 minutes. In total, the analysis lasts 2 hours.
All test results are recorded in a graph that allows you to get an accurate picture of the patient's metabolism. After taking a glucose patient has an increase in blood sugar, which in the language of medicine is called the hyperglycemic phase. During this phase, doctors determine the characteristics of glucose absorption.
In response to an increase in the concentration of sugar in the body, the pancreas begins to produce insulin, which helps reduce blood glucose levels. Doctors call this process the hypoglycemic phase. It reflects the amount and rate of insulin production, and also helps to assess the sensitivity of internal tissues to this hormone.
In type 2 diabetes mellitus and prediabetes, significant disorders of carbohydrate metabolism are observed during the hypoglycemic phase.
Such a test is an excellent tool for detecting diabetes at the very early stage of an illness when it is almost asymptomatic.
Urine Sugar Test
By the time of collection of biological material, this analysis is divided into two categories - morning and daily. The most accurate result is the daily analysis of the urine, which provides for the collection of all the excreted urine within 24 hours.
Before you begin collecting material for analysis, it is necessary to properly prepare the container. First you need to take a three-liter bottle, wash it thoroughly with dishwashing detergent, and then rinse with boiled water. It is also necessary to deal with a plastic container in which all collected urine will be transported to the laboratory.
The first morning urine should not be collected, since for its research there is a separate type of analysis - the morning one. So that the collection of biological fluids must begin with the second trip to the toilet. Before this, you must carefully wash away with the use of soap or gel. This will prevent microbes from the genitals in the urine.
A day before collecting urine for analysis should:
- Refrain from physical exertion
- Avoid stress
- There are no products that can change the color of the urine, namely: beets, citrus, buckwheat.
Laboratory tests of urine helps to determine the amount of sugar excreted by the body per day. In a healthy person, the level of glucose in urine is no more than 0.08 mmol / l. This amount of sugar in the urine is extremely difficult to determine using even the most modern laboratory methods of research. Therefore, it is considered that in healthy people, glucose in the urine is absent.
The results of the study of urine sugar content:
- Below 1.7 mmol / l is normal. This result, although more than the usual figure for healthy people, is not a sign of pathology,
- 1.7 to 2.8 mmol / l - predisposition to diabetes. Take the necessary steps to reduce sugar,
- Above 2.8 - diabetes.
Doctors endocrinologists consider the presence of glucose in the urine to be one of the earliest signs of diabetes. Therefore, this analysis helps to promptly diagnose the patient.
Analysis of fructosamine level
Fructosamine is an element that promotes the interaction of sugar with plasma proteins. Having determined the amount of fructosamine, it is possible to reveal an elevated level of glucose in the blood of a patient with diabetes mellitus. Therefore, this type of diagnosis is often used for making an accurate diagnosis.
Help determine the level of fructosamine biochemical blood tests. Blood biochemistry is a difficult analysis, so you must pass it on an empty stomach. A blood test for biochemical sugar is performed exclusively on an outpatient basis.
Moreover, between the last meal and blood sampling should take at least 12 hours. Therefore, to pass this type of laboratory diagnosis is best in the morning after sleep.
Alcohol can seriously affect the test results, so the last intake of alcohol should be no less than a day before the analysis. In addition, to obtain an objective result, it is not recommended to smoke cigarettes immediately before dough.
- From 161 to 285 - the norm
- Over 285 - diabetes.
It is important to note that high fructosamine is sometimes observed in patients with hypothyroidism and renal failure. And in conclusion, we offer a video in this article with the topic of diagnosing diabetes.