December 21, 2011
Important Tests Needed By People With Diabetes - P3
The discussion of this blog will be about tests doctors should use to track your diabetes and related possible complications. The first test helps analyze the status of your kidneys, liver, blood proteins, electrolytes, and acid/base balance. This is a Comprehensive Metabolic Panel (CMP) and is typically a group of 14 specific tests that have been approved, named, and assigned a CPT code (a Current Procedural Terminology number) as a panel by Medicare. Read about the different tests here.
The CMP includes these tests: glucose and calcium; albumin and total protein (proteins); electrolytes – sodium, potassium, CO2 (carbon dioxide, bicarbonate), and chloride; liver tests - ALP (alkaline phosphatase), ALT (alanine amino transferase, also called SGPT), AST (aspartate amino transferase, also called SGOT), and Bilirubin; kidney tests - BUN (blood urea nitrogen) and creatinine.
Next is the Basic Metabolic Panel (BMP), a group of 8 specific tests that have been approved, named, and assigned a CPT code. Many doctors use this test instead of the CMP. Read about the different tests here and compare to the CMP. Both tests are done from a blood draw. Neither the BMP or CMP are diagnostic in nature, but can help the doctor decide if more specific tests need to be completed for diagnosis of a problem.
The BMP includes these tests: glucose and calcium; electrolytes – sodium, potassium, CO2 (carbon dioxide, bicarbonate), and chloride; kidney tests - BUN (blood urea nitrogen) and creatinine.
More of us are probably familiar with the cholesterol tests (lipid panel). This is a group of tests that should be performed on a quarterly basis, but may not be if you have had no problems in the past. This is a very important groups of tests and give the doctor good information about cardiovascular health. The lipid profile is a group of tests done to determine the risk of coronary heart disease and are good indicators if someone is likely to have a heart attack or stroke caused by blockage of blood vessels or atherosclerois (hardening of the arteries. Read about the different tests that make up the lipid panel here.
The lipid profile normally includes - total cholesterol, high-density lipoprotein cholesterol (HDL-C) — often called good cholesterol, low-density lipoprotein cholesterol (LDL-C) —often called bad cholesterol, and triglycerides. An extended profile may also include very low-density lipoprotein cholesterol (VLDL-C) and non-HDL-C. Some labs also include ratios in the test results.
The last test in this group is the microalbumin test for kidney damage. This test is preferred annually if you have diabetes or hypertension and is extremely important for those not managing their diabetes or hypertension. For those with higher A1c's that are not managing their diabetes, the tests may be done more frequently. It screens for metabolic and kidney disorders plus urinary tract infections.
You will be asked to collect either a random sample of urine while you are at the doctor's office or laboratory, a timed urine sample (such as 4 hours or overnight), or you may be requested to collect a complete 24-hour urine sample. Your doctor or the laboratory will give you a container and instructions for properly collecting a timed or 24-hour urine sample.
The National Kidney Foundation recommends that everyone with diabetes between 12 and 70 years of age have a urine test for microalbuminuria at least once a year. According to the American Diabetes Association, everyone with type 1 diabetes should be tested annually, starting 5 years after onset, and all those with type 2 diabetes should start at the time of diagnosis.
If microalbuminuria is detected, it should be confirmed by retesting and, if positive on 2 of 3 determinations over a 3-6 month period, it is considered to be present and appropriate treatment should be given. Patients with hypertension may be tested at regular intervals, with the frequency determined by their doctor.
Part 3 of 4