Zest Diabetes care has arrangements for the following laboratory investigations
1) DIABETES
Blood Sugar (Fasting) Blood sugar (PP) HbA1c
2) BLOOD CELL PROFILE
Complete Blood Count (CBC) Erythrocyte Sedimentation Rate (ESR)
3) KIDNEY PROFILE
Serum Creatinine Estimated GFR Urea Uric Acid Urine ACR (Albumin Creatinine Ratio) Urine Routine
4) LIVER PROFILE
S. Alkaline Phosphatase S. Bilirubin Gamma GT S. Proteins SGOT SGPT
5) LIPID PROFILE
Total Cholesterol Serum Triglycerides LDL Cholesterol HDL Cholesterol VLDL Cholesterol Total Cholesterol/ HDL Ratio LDL/HDL Ratio
6) THYROID PROFILE
Free T3 Free T4 TSH
DIABETES CHECK
Blood sugar testing provides useful information for diabetes management. It helps to monitor
Progress of treatment towards reaching and maintaining blood sugar levels Effect of diet and exercise on blood sugar levels Fluctuations in blood sugar levels due to any illness or stress Effect of diabetes medications on blood sugar levels Unusual fluctuations in blood sugar levels due to any other cause
FASTING BLOOD SUGAR (FBS)
Ideally, the fasting blood sugar level should be in the range of 70 – 110 mg/dl.
POST PRANDIAL BLOOD SUGAR (PPBS)
The ideal post prandial blood sugar level is between 70 – 140 mg/dl.
GLYCOSYLATED HAEMOGLOBIN (HbA1c)
The term HbA1c refers to amount of glycosylated haemoglobin. It occurs when the glucose in the blood attaches to haemoglobin (a protein within the red blood cells). The level of attachment is reported in percentage and it reflects the average blood glucose level in the previous 3-4 months (the average life span of red blood cells).
COMPLETE BLOOD COUNT
A complete blood count (CBC) is a blood test done to obtain information about the condition of various cells in the blood such as white blood cells, red blood cells and platelets. Abnormally high or low counts may suggest the presence of different forms of disease and provide an overview of a patient’s general health status.
CBC is done to monitor overall health, to screen for some diseases, to confirm a diagnosis of some medical conditions, and to monitor changes in the body caused by medical treatments.
A complete blood count normally includes:
Red Blood Cells (RBC): The total number of red cells is given as an absolute number per litre. Iron deficiency anaemia presents as low RBC count.
White Blood Cells (WBC): The total white blood cells are given as absolute numbers whereas, all the white cell types are given as a percentage. A high WBC may indicate an infection.
Haemoglobin: The amount of haemoglobin in the blood is expressed in grams per decilitre. A low level of Haemoglobin is a sign of anaemia.
Platelets: The total number of platelets are given, as well as information about their size and the range of sizes in the blood.
Anaemia and infections are common in people with diabetes and hence, whenever, these conditions are suspected, information on the CBC is sought for deciding appropriate correction therapy.
ESR – Erythrocyte Sedimentation Rate
The rate at which red blood cells settle in a tube of blood under standardized conditions. A high rate usually indicates the presence of inflammation
KIDNEY PROFILE
High blood sugar and high blood pressure can lead to kidney disease. Diabetes can make the kidneys lose their ability to filter out waste products and can lead to kidney failure
Serum Creatinine
Creatinine is a waste product which is released by the body cells during normal wear and tear of muscle cells of the body. It is filtered freely by the kidneys and is currently the best reflector of kidney function. In people with damage to the kidneys, the level of creatinine in the blood increases. Creatinine levels in the blood can vary, and each laboratory has its own normal range. Higher levels may be a sign that the kidneys are not working properly. As the kidney disease progresses, the level of creatinine in the blood increases.
Urea
Blood urea nitrogen (BUN) testing is part of kidney profile. Urea production occurs primarily in the liver and is excreted by the kidneys. The BUN level may reflect functioning of the liver and/or kidneys.
Uric Acid (UA):
Uric acid is produced from the natural breakdown of your body’s cells and from certain foods. Most of the uric acid is filtered out by the kidneys and passes out of the body in urine. High levels of uric acid in the blood can cause solid crystals to form within joints and may also cause kidney stones or kidney failure.
Urine Albumin Creatinine Ratio
Urine albumin and estimated glomerular filtration rate (eGFR) are the two key markers for chronic kidney disease (CKD). Annual assessment of urine albumin excretion to diagnose and monitor kidney damage in patients with diabetes is recommended to compare the amount of albumin in the sample against its concentration of creatinine (UACR).
Urine Routine
Urine Routine is carried out to assess
- The presence of red and white blood cells
- The presence of bacteria or other organisms
- The presence of substances, such as glucose and protein
- The pH, which shows the acidic or basic nature of the urine
- The concentration of the urine
LIPID PROFILE
The lipid profile includes estimation of
Total Cholesterol
Cholesterol is part of the outer membrane of cells in in the body and is essential for life. It is used to make hormones that are essential for development, growth and reproduction. The level of Cholesterol in the blood is the total sum of cholesterol derived from food and the body’s own production of cholesterol, which takes place in the liver. Total cholesterol measures all cholesterol (good and bad) that is in the blood.
Serum Triglycerides
Triglycerides are the body’s storage form of fat. Most triglycerides are found in fat (adipose) tissue, but some circulate in the blood to provide fuel for muscles to work. Extra triglycerides are found in the blood after eating a meal — when fat is being sent from the gut to fat tissue for storage.
Low density Lipoprotein (LDL)
LDL cholesterol is termed as bad cholesterol as it deposits excess cholesterol in the walls of blood vessels and contributes to atherosclerosis or hardening of the arteries, leading to heart disease and blocking of blood supply to heart muscles. In people with type 2 diabetes, LDL cholesterol is often smaller and denser than those without diabetes.
High density lipoprotein (LDL)
HDL is a type of lipoprotein that carry cholesterol in the blood. HDL is supposed to be beneficial because it removes excess cholesterol from the tissues and carries it to the liver for disposal. Hence HDL cholesterol is often called “good” cholesterol.
LIVER PROFILE
The Liver plays an important role in glucose metabolism and is primarily responsible for maintaining adequate glucose supply in the blood during fasting states and in between meals. Liver transaminases (SGOT and SGPT) are useful biomarkers of liver injury. Most liver diseases cause only mild symptoms initially, but these diseases must be detected early. Hepatic (liver) involvement in some diseases can be of crucial importance. Some tests are associated with functionality (e.g., albumin), some with cellular integrity (e.g., transaminase), and some with conditions linked to the biliary tract [gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase].
The various liver function tests are
- Serum Albumin
- SGOT
- SGPT
- GGT
- Serum Alkaline phosphatase
- Total bilirubin
- Direct bilirubin
- Indirect bilirubin
The above tests can be used to detect the presence of any suspected liver disease, distinguish among different types of liver disorders, grading the extent of liver damage, and monitor the response to treatment and to ensure that some of the prescribed medications are not causing any harm to the liver.
THYROID PROFILE
Thyroid hormones regulate energy metabolism and affect nearly every organ in the body. Thyroid hormones also affect brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycle, weight, and cholesterol levels. Presence of thyroid dysfunction is commonly seen in people with diabetes and may adversely impact diabetes control
The thyroid profile consists of
Free Thyroxin (T4)
Free Thyroxin is generally elevated in hyperthyroidism and on the lower side in hypothyroidism.
Free Triiodothyronine (T3)
Free Triiodothyronine is generally elevated in hyperthyroidism and on the lower side in hypothyroidism
Thyroid stimulating hormone (TSH)
It is the most sensitive test for thyroid hormone function. TSH is produced in the pituitary gland. The production of TSH is controlled by TRH, which is produced in the hypothalamus. TSH levels may be suppressed by excess free T3 or free T4 in the blood.