Everything diabetes


Please note that no content on this blog should ever be used as a substitute for direct medical advice from your doctor or a qualified clinician.

Step 1 to avoid diabetic complications: Do routine tests

As far as I remember, I never took blood tests except to check my blood group (once) and hemogram (a couple of times) for 25 years of my life. If I had taken a few routine tests for all these years, I’d have a better snapshot of my overall health. I could have avoided DKA, hospitalization, and the trauma after. But better late than never!

I have learned a lesson for life - not to take my body for granted, and take routine tests religiously.

While it’s true that medical treatments are heavy on one’s pocket, it’s always in one’s best interest to take some routine blood tests. Because everyone deserves - a) peace of mind if the results are good and/or b) timely diagnosis if the results are not encouraging. Let’s talk about routine tests that everyone should take at least once a year (T1Ds are encouraged to take these tests every six months):

  1. Complete Blood Count (CBC): This test is a primary test to detect diseases that affect the blood cells (white blood cells, red blood cells, and platelets) such as anemia, infections, blood-related disorders, autoimmune diseases, cancer, etc. It gives your doctor a quick view of the count of the cells, hemoglobin, and hematocrit.
  2. Blood Glucose: Fasting BG, Postprandial BG, Glycated Hemoglobin (HbA1c): This test is used to determine the blood glucose levels at a given time - 10-12 hours after dinner (Fasting), 2 hours after a meal (Postprandial), and 3 months average of plasma blood glucose concentration (HbA1c). Extremely high or low concentration of glucose  adversely affects every organ of your body. Thus, it’s important to test A1c after every 3 months at least.
  3. Blood Pressure: This test is performed to measure the pressure at which your heart pumps the blood through the arteries. It should be routinely performed as it uncovers hypertension, hypotension and other heart conditions.
  4. Urine Routine: This test detects various substances in the urine such as byproducts of normal and abnormal metabolism, cells, cellular fragments, and bacteria. It helps to uncover Urinary Tract Infections (UTI), kidney disorders (check for urea, creatinine, uric acid, albumin, microalbumin etc) ketone bodies and glucose buildup in the urine (DKA), etc.
  5. Lipid Profile: This test includes the level of Total Cholesterol, Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL), and Triglycerides. This test determines the risk of developing Cardiovascular Diseases.
  6. Thyroid Tests - Thyroid Stimulating Hormone (TSH), Triiodothyronine (T3), Thyroxine (T4): This test is performed to measure how well your thyroid gland is functioning as it's responsible to regulate the body’s metabolism, energy generation, and mood. It is useful to diagnose hyperthyroidism, hypothyroidism and other thyroid diseases.

If your Blood Glucose Test results do not meet the usually accepted target range for reference i.e. Fasting BG: 70 - 110 mg/dL, Postprandial BG: 70 - 150 mg/dL and HbA1c: 4 - 6%, you should visit a registered diabetologist immediately. Diabetes can happen to anyone irrespective of their age -  contradictory to popular belief that it occurs either in children under 10 (Type 1 Diabetes) or in adults above 40 (Type 2 Diabetes). Thus, it is extremely important to take some additional tests to determine the type of diabetes (Type 1 Diabetes, Type 1.5 Diabetes, Type 2 Diabetes, or Gestational Diabetes), and take corrective measures accordingly. Below are the tests that determine the type of diabetes:

  1. C-Peptide Test: The pancreas produces equal amounts of  C-peptide and insulin. Thus, this test shows the amount of insulin the body is releasing. This test is used to distinguish between the types of diabetes as people living with type 1 diabetes have low or nil C-peptide and insulin while people living with type 2 diabetes tend to have a higher amount of  C-peptide than the reference values.
  2. Anti Glutamic Acid Decarboxylase (GAD 65) Antibody Test: Pancreas need an enzyme called Glutamic Acid Decarboxylase (GAD 65) to function normally. Antibodies that target this enzyme are called as GAD 65 antibodies. This test is used to diagnose the presence of the antibodies and distinguish between types of diabetes.
  3. Essential Micronutrients Test - Vitamin B12, Vitamin D: High BG for long duration adversely affects calcium levels and bone metabolism. Also the deficiency of Vitamin B12 could lead to diabetic neuropathy. Thus, the tests to uncover the deficiency of these essential micronutrients have to be done at regular intervals.  
  4. Antithyroid Autoantibody Test: This test is used to evaluate autoimmune thyroid problems as these antibodies destroy the thyroid gland.
  5. Anti Tissue Transglutaminase Test (Celiac Disease - Gluten Intolerance):  This test is used to diagnose celiac disease which is an autoimmune disorder where body attacks a protein called gluten from wheat, barley and oats. It causes rashes diarrhea, and poor growth in children.

If you are diagnosed with diabetes, here are some additional routine tests:

  1. Neuropathy and foot exams: High amount of glucose in people living with diabetes for a long time can damage their blood vessels carrying oxygen and nutrients. A number of physical exams - blood pressure and heart rate, muscle strength, reflexes, sensitivity to position, vibration, temperature, or a light touch on the arms and legs are performed in order to measure the nerve damage in the respective areas of the body.
  2. Comprehensive eye exam: Uncontrolled blood glucose for a long period can damage the blood vessels in the retina resulting in diabetic retinopathy. A comprehensive eye examination should be done annually (and at diagnosis) in order to ensure good vision and o catch complications early.

Pricing and Report Generation:

  1. Most labs offer various test packages at discounted rates. The costs of these tests differ from lab to lab, city to city.
  2. Most of the test results are available in a day except for GAD 65 which takes more than a week and is expensive.

Step 2 to avoid diabetic complications: Consult a registered doctor and act on an action plan

The time and money invested in step 1 are futile unless you take step 2. Most of the test reports provide the reference range to interpret the result. It is essential to consult your doctor who can translate its meaning and provide medical advice in case of an issue. It is advisable not to rely on the internet and seek medical attention as early as possible for avoiding further complications.

The key to avoid any health related complication is taking tiny steps every day - exercise, nourishment, medication, and routine tests!


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