Glucose tolerance tests accuracy in diagnosing diabetes

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Glucose tolerance tests accuracy in diagnosing diabetes

Identifying patients at increased risk for diabetes prediabetes Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Diabetes mellitus is a chronic disorder associated with disturbances in carbohydrate, fat, and protein metabolism characterized by hyperglycemia.

It is one of the most prevalent diseases, affecting approximately 24 million individuals in the United States. Long-term treatment of the disease emphasizes control of blood glucose levels to prevent the acute complications of ketosis and hyperglycemia.

Normal and diabetic blood sugar ranges

In addition, long-term complications such as retinopathy, neuropathy, nephropathy, and cardiovascular disease can be minimized if blood glucose levels are effectively controlled.

Hemoglobin A1c HbA1c is a result of the nonenzymatic attachment of a hexose molecule to the N-terminal amino acid of the hemoglobin molecule. The attachment of the hexose molecule occurs continually over the entire life span of the erythrocyte and is dependent on blood glucose concentration and the duration of exposure of the erythrocyte to blood glucose.

Therefore, the HbA1c level reflects the mean glucose concentration over the previous period approximately weeks, depending on the individual and provides a much better indication of long-term glycemic control than blood and urinary glucose determinations. Diabetic patients with very high blood concentrations of glucose have from 2 to 3 times more HbA1c than normal individuals.

The threshold is based upon sensitivity and specificity data from several studies. Advantages to using HbA1c for diagnosis include: Patients who have an HbA1c between 5.

The terms prediabetes, impaired fasting glucose, and impaired glucose tolerance will eventually be phased out by the ADA to eliminate confusion.

The ADA recommends measurement of HbA1c typically times per year for type 1 and poorly controlled type 2 diabetic patients, and 2 times per year for well-controlled type 2 diabetic patients to determine whether a patient's metabolic control has remained continuously within the target range. Reference Values Describes reference intervals and additional information for interpretation of test results.

May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this. Increased risk for diabetes prediabetes: Since the HbA1c assay reflects long-term fluctuations in blood glucose concentration, a diabetic patient who has in recent weeks come under good control may still have a high concentration of HbA1c.

The converse is true for a diabetic previously under good control who is now poorly controlled. HbA1c results less than 4. HbA1c may not accurately reflect glycemic control when clinical conditions that affect erythrocyte survival are present. Fructosamine may be used as an alternate measurement of glycemic control.

The advantage of using ion exchange chromatography methods is most variants that would affect HbA1c results can be detected from analysis of the chromatogram so inaccurate results are less likely to be reported. If the specimen cannot be analyzed due to a homozygous variant or other interference, measurement of serum fructosamine may be helpful to monitor glycemic control.

Some hemoglobinopathies can be associated with reduced red blood cell RBC lifespan and any measured HbA1c concentration would not provide a true measurement of the patient's glycemic control and could lead to misinterpretation. In such situations, fructosamine should be used as an alternate measurement of glycemia and is recommended for monitoring these patients.

In cases of hemolytic anemia, the lifetime of erythrocytes is shortened and will result in decreased HBA1c results. This effect will depend upon the severity of the anemia.A1C is an integrated measure of circulating glucose levels and tracks well in individuals over time.

Epidemiological studies have shown that A1C values in nondiabetic adults predict incident diabetes (1–5), cardiovascular disease morbidity and mortality (6–10), and total mortality ().In these studies, A1C values well within in the “normal” range (i.e., A1C.

Dec 31,  · There are an increasing number and type of cardiac tests used to help stratify patients thought to be at risk for symptomatic coronary artery disease (CAD), specifically for short-term complications such as myocardial infarction (MI) or sudden cardiac death.

As for the current gold standard for diagnosing diabetes, the oral glucose tolerance test (OGTT) has its limitations (2). These include high interindividual variability, low reproducibility compared to FPG, poor compliance with the conditions needed to perform the test correctly, and is cumbersome and time-consuming for medical staff and .

Just be aware, this is taking into consideration average of all values including both fasting and post-meal. Because the A1c is an overall 3 month average, it isn’t possible to answer your question exactly because blood glucose is measured daily.

Glucose Tolerance Tests Accuracy In. Diagnosing Diabetes According to the World Health Organization (WHO), more than million people worldwide have. To confirm the diagnosis of type 2 diabetes, your doctor will order a fasting plasma glucose test or a casual plasma glucose.

Glucose tolerance tests accuracy in diagnosing diabetes

Diabetes and the Fasting Plasma Glucose Test The fasting plasma glucose test (FPG) is the preferred method for diagnosing diabetes, because it is easy to do, convenient, and less expensive than other tests, according to .

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