Diabetes Testing

Question 1

What are the numbers for impaired fasting glucose?

Answer 1

100-125

Question 2

What are the numbers for impaired glucose tolerance?

Answer 2

140-199
fasting greater than or equal to 95
1 hour 180
2 hours 155
3 hours 140
-requires two or more thresholds to be met

Question 3

What is the fasting blood sugar needed for diagnosis of diabetes?

Answer 3

greater than or equal to 126

Question 4

What A1C level diagnosis diabetes and what are the numbers for treatment goals?

Answer 4

greater than 6.5%

goal: 7%

Question 5

What time of sample do you need for diagnosis of diabetes?

Answer 5

plasma sample

Question 6

What factors indicate screening for diabetes should be done?

Answer 6

BMI over 25 and 1 or more risk factor

Question 7

Without risk factors when should someone be screened for DM?

Answer 7

age 45 and older

Question 8

What are the screening tests for DM?

Answer 8

• A1C
• fasting plasma glucose
• 2 hour oral glucose tolerance test

Question 9

How does stress increase blood sugar?

Answer 9

hormone release during stressful times as part of the fight or flight response

Question 10

What are 6 conditions that can affect BG levels?

Answer 10

• cushing’s
• acromegaly
• pheo
• glucagonoma
• liver dz
• pancreatitis

Question 11

When are venous glucose levels higher than capillary levels?

Answer 11

-fasting and random testing

Question 12

When are venous glucose levels lower than capillary?

Answer 12

-2 hours after oral glucose load

Question 13

What does hemoglobin A1C represent and what are the normal values?

Answer 13

-glucose irreversibly binds to the RBC and gives a 2-3 month average blood sugar
over 6.5 is diabetic
5.7-6.4 abnormal
less than 5.7 normal

Question 14

What are some conditions that can affect the results of an A1C test?

Answer 14

• genetic variants: HgbS, HgbC

- any condition shortening RBC survival or age (ex: acute blood loss recovery, hemolytic anemia)

Question 15

Factors increasing A1C

Answer 15

• iron deficiency anemia
• alcohol toxicity
• lead toxicity
• late pregnancy d/t iron deficiency anemia

Question 16

Factors decreasing A1C

Answer 16

• hemolytic anemia
• chronic blood loss
• pregnancy
• chronic renal failure

Question 17

How often do you do routine testing of A1C?

Answer 17

• 2 x year if meeting tx goals

- quarterly if medication change or not meeting tx goals

Question 18

What is fructosamine?

Answer 18

a 1-2 week average blood glucose obtained from a serum sample

• -it measures ketoamines
• not widely used anymore

Question 19

What are ketones the result of?

Answer 19

fatty acid metabolism that increases when not enough insulin is available to use glucose as energy

Question 20

When do you test for ketones?

Answer 20

pregnancy
BG > 300
suspicious for DKA

Question 21

What 5 things can cause a false positive ketonuria test?

Answer 21

levodopa
phenazopyrine
valproic acid
vitamin c
dehydration

Question 22

When can glucosuria be detected?

Answer 22

BG over 160-180

-leads to osmotic diuresis

Question 23

To show up on a urine dipstick albuminuria has to exceed

Answer 23

300

Question 24

What are the values for microalbuminuria?

Answer 24

30-300

Question 25

How do you diagnose diabetic nephropathy?

Answer 25

confirm a positive result with additional tests over the next 3-6 months–2 out of 3 samples that are abnormal in a 6 month period confirm the diagnosis