Many different instabilities can be related to getting hyperglycemia, type 2 diabetes, and insulin resistance. Commonly, a few basic tests are being done just to evaluate type 2 diabetes due to various reasons. Probably, this may lead to improper evaluation of the real disease. Can you tell that which tests can be done to evaluate all possibilities/conditions related to hyperglycemia, type 2 diabetes, insulin resistance, etc.?
In the U.S., initial evaluation of patients with hyperglycemia or diabetes runs something like this:
- For a high blood sugar above 126 mg/dl [7.0 mmol/L], if it is confirmed, the diagnosis is diabetes. The diagnosis requires elevated levels on more than one occasion.
- You can check C-Peptide with the glucose to see if the value is appropriately elevated or not. If it is elevated, it is more likely type 2 diabetes.
- Islet cell markers of autoimmunity include anti-GAD, anti-ICA, and insulin autoantibodies. If these are high, they indicate type 1 diabetes.
- The above, in addition to clinical indicators, are generally what are used to make a diagnosis of type 1 or type 2 diabetes.
There are additional things that can be done and may occur with a research study, that give more information about correct assignment of type 1 or type 2 diabetes. These include such things as the following:
- Serial oral glucose tolerance testing or mixed meal challenge testing. Some of those with type 1 diabetes may have presentation like type 2 at first, but may have a fall off in beta cell function. These tests can pick that up.
- I.V. glucose tolerance testing to evaluate beta cell function.
- Measures of insulin resistance, which include clamp tests, minimal model analysis, or use of fasting glucose and insulin responses.
Original posting 14 Jan 2007
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Last Updated: Tuesday April 06, 2010 15:10:10
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