Question

1. What are the laboratory tests (blood tests) that should be monitored in a patient with diabetes mellitus? What are the normal values?

2. What is the relationship between diabetes mellitus and renal failure?

Answer 1

The investigations that need to be done include:

• Fasting blood sugar: a value more than 100 indicates insulin resistance while a value more than 126mg/DL indicates diabetes. Normal value is less than 100
• Post prandial blood sugar: 2 hours after meal- value. A value more than 140 indicates insulin resistance and more than 200 indicates diabetes. Normal value is less than 140.
• Hba1c: more reliable estimate of long term glycemic control. Glucose in blood binds with hemoglobin of RBCs. Since RBCs have a life span of 120 days, HbA1c is thought to be a good estimate of glucose control over past 3 months. Normal value is less than 5.7%, 5.7 to 6.5% indicates prediabetes and more tha. 6.5% indicates diabtes.
• Renal function tests and serum electrolytes. Since diabetes is a cause of chronic kidney disease, RFT and serum electrolytes should be monitored from time to time. S. Creatinine values till 1.5 are considered normal in most.

Diabetes is a prominent cause of chronic disease. Diabetes is associated with microvascular complications which include diabetic nephropathy, diabetic retinopathy and diabetic neuropathy.

These occur due to intracellular sorbitol accumulation, accumulation of abnormal end glycosylation products, free radical damage etc.

These changes accumulate over time and cause chronic failure of the kidneys. Good blood sugar control can prevent this.