19 + 20. Evaluation of gliycemia for preceded period of time | Selection of clinical laboratory tests in detecting and tracking disturbance of carbohydrate metabolism in patients w/ DM

Question 1

What is Glycosylated Hemoglobin?

Answer 1

Aka Glycohemoglobin, HbA1c

When Glucose molecules attach to HbA = Glycosylation

Question 2

When Must HbA1c NOT BE USED for Diagnosis?

Answer 2

Pregnant Women

Recent Severe Bleeding

Blood Transfusion

Chronic Kidney / Liver Disease

Iron Deficiency Anemia

Vitamin B12 Anemia

Question 3

What are the Indications for Investigation HbA1c?

Answer 3

Diabetes Therapy

Whether Treatment is Oral Hypoglycaemics, Insulin or a COMBO of Both

Question 4

What is the Purpose of Investigation HbA1c?

Answer 4

Average Blood Sugar Level

Of the Previous 2/3 MONTHS

Measuring the % of Hb in RBCs that have Glucose attached

Question 5

How is the Patient Prepared for HbA1c Investigation?

Answer 5

NO Restrictions on

• Food
• Fluids
• Medication

Question 6

What Specimen is Used for HbA1c Investigation?

Answer 6

Venous Blood WITH Anticoagulant, EDTA

Question 7

What is the Reference Range of HbA1c?

Answer 7

6% or LESS = Normal

Question 8

What does the HbA1c Value of OVER 7% Indicate?

Answer 8

Diabetes Control is NOT Good

Question 9

What is the Hb1Ac Value of Diabetics?

Answer 9

MORE than 6.5%

Question 10

What is the Hb1Ac Value of Normal People?

Answer 10

LESS than 6%

Question 11

What does the HbA1c Value of BETWEEN 6 - 6.5% Indicate?

Answer 11

Pre-Diabetes

AT RISK of Diabetes

Question 12

What is Fructosamine?

Answer 12

End Product of Non-Enzymatic Reaction

BETWEEN Glucose + Amine from Albumin

Aka Glycated Serum Protein

Question 13

What is the Purpose of Glycated Proteins?

Answer 13

They Determine the AVERAGE Glucose

Over Past 2/3 WEEKS

Question 14

What is the Indication of Fructosamine Investigation?

Answer 14

Circumstances

Where HbA1c CANNOT be Measured Properly

Question 15

At What Circumstances is Fructosamine is Investigated, INSTEAD of HbA1c?

Answer 15

1. Rapid Change in Diabetes Treatment
2. Diabetic Pregnancy
3. RBC Loss / Abnormalities

Question 16

What Specimen Is Used for Fructosamine Investigation?

Answer 16

Serum

Question 17

What is the Reference Range of Fructosamine?

Answer 17

285 µmol / L

Question 18

What is the MEAN Reference Range of Fructosamine?

Answer 18

240 µmol / L

Question 19

What is the Reference Range of Fructosamine, in COMPENSATED DIABETES?

Answer 19

UP-TO 350 µmol / L

Question 20

What is the Reference Range of Fructosamine, in DECOMPENSATED DIABETES?

Answer 20

OVER 350 µmol / L

Question 21

What do Normal Fructosamine Levels Indicate?

Answer 21

Not Diabetic

Has Good Diabetic Control

Question 22

What do HIGH Fructosamine Levels Indicate?

Answer 22

Patient’s Average Glucose over the Last 2/3 WEEKS

HAS ELEVATED

HIGH Fructosamine = HIGH Blood Glucose Levels

Question 23

What is Microalbuminuria?

Answer 23

Kidney Leaks SMALL AMOUNT of Albumin

INTO Urine

30 - 300mg of Albumin a DAY

Question 24

What are the Indications of Microalbumin Investigation?

Answer 24

Risk for Developing Kidney Disease

Diabetes

Hypertension

Question 25

What is the Reference Ranges of Microalbumin?

Answer 25

Normal = UP TO 20 µg / min

OTHERWISE

• 20 -200 µg / min
• 30 - 300 mg / 24h

Question 26

What Do the Levels of Microalbumin Indicate?

Answer 26

Normal Kidney Function

Otherwise Risk of Developing Kidney Disease

Question 27

What is C-Peptide?

Answer 27

Pro-Insulin Molecule

Linking alpha + beta chains of insulin

Question 28

What is the Purpose of C-Peptide?

Answer 28

Monitors Insulin Production

Helps to determine Cause of LOW BGL

Question 29

What Specimen Is Used for C-Peptide Investigation?

Answer 29

Serum

Question 30

What are the Reference Ranges for C-Peptide?

Answer 30

Fasting C-Peptide Levels

0.34 – 1.803 nmol / L

Question 31

What do HIGH C-Peptide Levels Indicate?

Answer 31

HIGH Levels of Endogenous Insulin Production

Insulinoma

Hypokalemia

Renal Failure

Question 32

What do LOW C-Peptide Levels Indicate?

Answer 32

LOW Levels of Insulin Production