Blood Sugar- Fasting

 After atleast 10 hrs of overnight fasting-water can be taken in the morning

This test reflects the glucose output by the liver during the night which inturn is increased due to decreased secretion of insulin or high rates of secretion of glucagons by the pancreas

Normal

Prediabetic

Diabetic

Less than 125 mg/dl

between 126-140 mg/dl

 above 140 mg/dl

Frequency

1-3 months

Blood Sugar- Post-Prandial

( 2 hrs after taking breakfast or 75 gms of glucose)

This test reflects the capacity of pancreas to respond to a glucose load i.e when sugar level starts rising in the blood due to food intake

Normal

Prediabetic

Diabetic

Less than 140 mg/dl

between 140-199 mg/dl

above 200 mg/dl

Frequency

1-3 months

HbA1C  (Glycosylated Hemoglobin)

Can be done at any time, does not require any fasting state

Glucose present in blood gets irreversibly attached to the B-chain in Hemoglobin molecule and remains there through out its lifespan of approx. 90 days. Indicates the exposure of RBC and Hemoglobin to high blood sugar levels

Reflects the average blood glucose level of approx past 3 months. This test is of more value in management of Diabetes than in initial diagnosis

Frequency

1-3 months

Normal

Diabetic with good control

Diabetic � requires intervention

Diabetic- poorly controlled

Less than 6.1%

6.2-7 %-

7-8%-

above -8%-

Fructosamine

Fructosamine or glycated albumin measures short term control of blood sugar for the past 2-3 weeks..  Its helpful where monitoring of short-term glucose level is required, or in case of hemoglobinopathy�s ( like sickle cell anemia etc), acute blood loss, hemolytic anemia also during pregnancy and states where there have been significant changes in diet, or medication, See comparison table below

Below  250�mol

Each 75 �mol change equals a change of approximately 60 mg/dl blood sugar or 2% HbA1c

Frequency

1-3 weeks if indicated

Lipid Profile

  ( 10 hrs of overnight fasting , water can be taken)

This test reflects the levels of different types of fats and Lipoproteins ( proteins carrying fats )in the blood. Diabetes may cause high levels of cholesterol and triglycerides in blood which result in atherosclerosis and subsequent blockage of  blood vessels supplying blood to heart or brain

Total cholesterol

Less than 150

Triglycerides

Less than 150 mg/dl

HDL Cholesterol ( good or protective cholesterol)

More than 50

LDL Cholesterol ( Harmful cholesterol)

Less than 100 ( If no overt CVD)

Less than 70 ( If overt CVD present)

Frequency

 Every six to 12  months or earlier

Microalbumin 24 hrs

( Total collection of urine passed in 24 hrs, from morning of day 1� day 2)

Reflects earliest signs of damage to the kidneys.

Indicates the quantity of micro albumin ( smallest protein molecules present in blood) being filtered by by kidneys into the urine- in healthy state protein molecules do not filter out of blood.

Normal function

Microalbuminuria

Macroalbuminuria

less than 30 mg/24 h

30�299 mg/24 h

more than 300 mg/24 h

Frequency

3-6 months

Spot Microalbumin Creatinine ratio

( Single early morning sample )

Reflects earliest signs of damage to the kidneys.

Indicates the quantity of micro albumin ( smallest protein molecules present in blood) being filtered by by kidneys into the urine- in healthy state protein molecules do not filter out of blood.- this does not require a 24 hrs collection

Normal function

 Microalbuminuria

 Macroalbuminuria

  Less than 30�g/mg creatinine

   30�299�g/mg creatinine

  More than 300�g/mg creatinine

Frequency

 3-6 months

Eye testing

Eyes should be checked by an ophthalmologist ( specialist eye doctor) to rule out any complications of diabetes like Diabetic Retinopathy.

Once a year

Testing for peripheral Neuropathy

Vibration, Hot and cold perception testing of the feet should be done atleast once in a year or six months depending on the duration of Diabetes and level of sugar control- early diagnosis of peripheral neuropathy  may help to prevent leg/ foot ulcers and subsequent leg amputations

Once-twice a year

Electorcardiography, TMT

These tests would assess the condition of heart and presence of  Coronary vascular disease ( blockage of the blood vessels supplying blood to the heart itself). Early diagnosis of CVD may prevent heart attacks and angina episodes.

Once a year or as required