Testing

DIABETES TESTING

Regular blood glucose testing by people with diabetes is important to help control it, and also prevent long-term complications. Good control of blood glucose levels can prevent or reduce serious complications.

Frequent testing can show how changes in diet, exercise, medications or weight are having an effect on a patient’s diabetes.

Close monitoring of blood glucose levels allows control and timely intervention to prevent diabetic complications.

Why is testing important for diabetic patients?

Regular monitoring of blood sugar levels (blood glucose) gives valuable information as to whether the level is within the normal range.

If kept in control, this can delay the onset or development of long term diabetic complications, which can even be life-threatening.

People with type 1 and type 2 diabetes can monitor their blood sugar themselves, by using thumb prick blood tests which are available as home kits. Self-monitoring is very important for long-term health.

What are the routine tests that are followed?

Regular self testing, recording of blood glucose levels by thumb prick blood tests, laboratory test of HbA1c (glycosylated haemoglobin) level a few times a year should be taken.

Other tests that should be performed routinely include: urine test to monitor kidney function; blood fat levels (cholesterol & triglyceride levels), and tests for kidney function.

Regular blood pressure measurement and treatment if needed.

Examination of the feet is also necessary, as the patient may not be aware of loss of sensation from early nerve damage.

Also, get eyes tested every 1 to 2 years, depending on test results.

How is diabetes and pre-diabetes diagnosed?

The following test are the normal tests whoich are used for diagnosis:

1. Fasting plasma glucose test –

This measures the blood glucose with a minimum gap of at least 8 hours without eating. It is best done on an empty stomach in the morning. This test is used to detect diabetes or pre-diabetes.

If a person’s fasting glucose level is 100 to 125 mg/dL, you have a form of pre-diabetes called impaired fasting glucose (IFG), meaning that one is quite likely to develop type 2 diabetes but does not have it yet.

A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that one is diabetic.

99 mg/dL and below – normal, not diabetic

100 mg/dL to 125 mg/dL – pre diabetic

126 mg/dL and above – diabetic.

2. Oral glucose tolerance test (OGTT) –

This measures the blood glucose after one has not eaten for least 8 hours, and then 2 hours after drinking 75 grams glucose-containing beverage. This test is used to diagnose diabetes or pre-diabetes.

This test is more sensitive than the fasting plasma glucose test for diagnosing pre-diabetes.

If 2 hours after drinking the liquid, the blood glucose level of a person is between 140 and 199 mg/dL, then it a form of pre-diabetes called impaired glucose tolerance or IGT, meaning that one is more likely to develop type 2 diabetes but does not have it yet.

Glucose level of 200 mg/dL or above, confirmed by repeating the test on another day, means that one has diabetes.

139 mg/dL and below – not diabetic, normal

140 mg/dL to 199 mg/dL – pre diabetes

200 mg/dL and above – diabetic

Gestational diabetes is diagnosed based on plasma glucose values measured during the OGTT. Blood glucose levels are checked four times during the test. If the blood glucose levels are above normal at least twice during the test, then the person has gestational diabetes.

3. Random plasma glucose test –

This measures blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes, but not pre-diabetes.

A random blood glucose level of 200 mg/dL or more, alongwith presence of the following symptoms, can suggest that one has diabetes:

· increased urination

· increased thirst

· unexplained weight loss

Other associated symptoms include fatigue, blurred vision, increased appetite, and sores that do not heal.

Test results are confirmed only after repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day.

What is HbA1c or the glycosylated haemoglobin test?

HbA1c (glycosylated haemoglobin) gets collected in red blood cells when they are produced. This gives a clue about the blood sugar levels over a couple of months – the average lifespan of a red blood cell. Thus, this test shows the average blood glucose level over time, as compared to the thumb prick test, which indicates blood glucose at the time of testing.

If the HbA1c level is above 7%, consult a doctor for a better diabetes management plan.

If the HbA1c level is above 8%, the doctor may change medication or a more intensive insulin regime be used.

The combination of HbA1c test and thumb prick test results give a better indication of variations in blood glucose levels than either test alone.

How often should blood sugar testing be done?

Diabetic patients who are taking insulin injections should self test 3-4 times everyday, especially before retiring to bed. Type 2 diabetic patients on medicines should self test around a few times every week.

It is best to check glucose levels first thing in the morning; and before and after meals. Keep changing daily test times to get a better idea of the changes to blood glucose levels.

For diabetes information, diabetes diet, diabetes treatment, diabetes causes visit www.diabetesmellitus-information.com

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The Prime Minister, Gordon Brown, announced in his key speech at this year’s Labour Party conference that he plans to bring in speedier testing for cancer in patients showing symptoms of the disease. This will mean earlier diagnosis and earlier treatment, and could potentially save thousands of lives. This promise is building upon what the NHS has already achieved since it received extra funding and brought down the age for breast cancer screening, which has already made a difference to many women’s lives.

In his speech, Gordon Brown pledged to “finance a new right for cancer patients to have diagnostic tests carried out, completed and with results – often same day results – within one week of seeing your GP. That is our early diagnosis guarantee, building on our current guarantee of only two weeks wait to see a specialist.” The Labour Party promises to meet this target by 2014.

Initially the proposal will be implemented for lung, colorectal and ovarian cancers, with other cancers being brought into the service within 5 years. Funding which has previously been used for making improvements to hospital buildings will now be used to provide more diagnostics equipment within GP surgeries and community hospitals, including CT scanners.

So how will this be implemented? Leading cancer expert, Professor Mike Richards, will be leading the new initiative and has stated that it will involve new roles for nurses who will play an important role in carrying out many of the tests, including endoscopies and ultrasounds. The investment in the initiative will create further training opportunities for nurses and could create more nurse jobs. Nursing jobs could also involve raising more awareness of cancerous symptoms, such as unexpected weight loss, changes in bowel habits, persistent coughing or noticeable changes to a mole or wart. This will build upon the nurse’s role in cancer care as rehabilitative carer, where they address rehabilitation issues for patients in teaching, counseling and guidance.

However, there is a fear that the new responsibilities could add pressure to nurses who are already buckling under the strain of a large workload. It could prove challenging to implement the gold standard of clinical examination, ultra sound and pathology in the shorter time frame, bringing into question the quality of the diagnosis as well as the speed.

The new early diagnosis will benefit those patients who show some cancerous symptoms but do not fulfill all the conditions for immediate referral to a specialist. For example, if a young woman found a small lump in her breast, she is below the common age for breast cancer, so may not be referred to a specialist so quickly. The new scheme will be particularly helpful in detecting ovarian cancer, which can be hard to spot as it presents indistinct symptoms. The chief executive of Ovarian Cancer Action, Peter Reynolds, has stated that most women with ovarian cancer were currently diagnosed with the disease at a later stage, making treatment harder and bringing the success rate down.

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When should I undergo a cholesterol test? What would the results say about my health? How many tests are there and which will give me the best results?

Unlike any other health tests, cholesterol testing does not diagnose disease. Instead, it reveals the risks of developing heart disease. Cholesterol testing is considered necessary in preventive health care for individuals over 20 years of age. The test should be repeated once every five years for healthy individuals.

Cholesterol testing, along with HDL, LDL and triglyceride testing is called the lipoprotein profile.

Cholesterol testing is done several times a year for individuals who are on a prescribed diet and for those who are taking cholesterol lowering medications.

Usually blood samples are drawn from the arm. Sometimes blood samples are taken from the fingertip. The samples are analyzed by a cholesterol testing device. Cholesterol tests are used to monitor the progress in lowering the cholesterol level.

Test results are grouped in three types:

* Desirable – the cholesterol level of 200 mg/dL below is regarded to be desirable because it has a low risk of heart disease.

* Borderline high – a total cholesterol level of 200 mg/dL to 240 mg/dL is at fair risk of having heart disease. Your doctor may decide to give you have a lipid profile in order to determine which cholesterol level is high.
* High Risk – a 240 mg/dL cholesterol level is considered to be at high risk of heart disease. Expect a lipid profiling if your cholesterol level is this high. It is more likely that you will be given a cholesterol lowering medication along with a low cholesterol diet.

Cholesterol tests are usually given when the individual is healthy because the blood cholesterol level of an individual who has an acute illness, (after a heart attack or after surgery or accident) is likely to be low. Individuals are advised to wait at least six weeks after any illness before taking cholesterol tests. Pregnant women are also advised to wait six weeks before having their cholesterol level measured.

A Brief Explanation of Cholesterol Ratios:

Cholesterol ratios consist of total cholesterol. Total cholesterol includes low level lipoprotein cholesterol levels (LDL cholesterol), triglycerides and high density lipoprotein cholesterol level (HDL cholesterol).

Cholesterol is measured by milligrams of cholesterol per deciliter of blood (mg/dL). Usually, only the total cholesterol amount is given when a person is tested for cholesterol. Sometimes you are given the HDL cholesterol and the total cholesterol results.

The desirable total cholesterol level is 200mg/dL and the beneficial amount of HDL is more than 40mg/dL.

There are two important cholesterol ratios. These they are LDL/HDL cholesterol ratios and total cholesterol/HDL cholesterol ratios.

In the latter cholesterol ratios, your cholesterol result is given by the total cholesterol divided by the HDL cholesterol. According to the American Heart Association, the desirable amount should be below 5:1 with the optimal amount of 3.5:1 or 3.5 to 1.

The LDL/HDL is done by dividing LDL cholesterol by the HDL cholesterol. The desirable amount in this ratio should be 3.5 below. The American Heart Association recommended that physicians must use complete numbers for total cholesterol/HDL cholesterol in determining the appropriate treatment.

A normal cholesterol level as suggested by the National Institute of Health:
* total cholesterol – 200mg/dL
* LDL – 100mg/dL
* HDL (man) – 40mg/dL above
* HDL (woman) – 50mg/dL above
* Triglycerides – 150mg/dL

It is important to remember to fast the night before, prior to taking a lipid profile test (a test that profiles the HDL cholesterol, triglycerides and total cholesterol) the next day.

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