Endocrinologists are involved in the treatment of people with diabetes mellitus (DM). They also recommend that laboratory tests be conducted annually to determine the presence or absence of the disease. Regular examination is one of the most effective measures to prevent the development of the disease. Few people know that metabolic disorders in the body often occur with minimal symptoms. Therefore, it is possible to diagnose pathology in the initial stages only with the help of tests carried out in laboratory conditions. Early detection of the disease prevents the development of serious complications.
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For what symptoms is it necessary to be tested for diabetes?
With constant monitoring of your own body, it is possible to recognize the initial degree of diabetes by certain signs. The symptoms depend on the stage and type of diabetes. People who develop type 1 diabetes have fairly severe symptoms that progress rapidly. The main primary symptoms are:
- Polyuria – increased urine output. It occurs against the background of an increase in osmotic pressure due to the dissolution of glucose in the urine. (In a normal healthy state of the body, glucose in the urine is not detected). This symptom manifests itself by frequent and profuse urination, especially at night;
- Polyphagia is an irrepressible constant hunger. It is associated with metabolic disorders, i.e. with the inability of cells to assimilate and transform glucose due to the lack of insulin;
- Polydipsia is constant thirst. It is caused by large losses of fluid that comes out with urine, as well as increased osmotic pressure in the blood;
- Exhaustion of the body, weight loss. It occurs due to the increased breakdown of fats and proteins due to the exclusion of glucose from the intercellular energy metabolism.
The accompanying picture is accompanied by itching of the skin, vaginal itching, dry mouth, headaches, general muscle weakness, complaints of vision, inflammatory skin manifestations, the presence of acetone in the urine, decreased sex drive, menstrual irregularities. The manifestations of the disease related to type 2 are more secretive. Most often, it is found during the planned delivery of a blood sugar test. Symptoms are more common in people over 40 and those who are overweight. Thirst and increased urination may not be noticeable. Also, type 2 diabetes is characterized by the following manifestations:
- deterioration of vision;
- fast fatiguability;
- ulcerative type formation on the legs (the so-called diabetic foot);
- pain in the bones during movement;
- itching and vaginal discharge in women;
- poorly treatable female thrush;
- the occurrence of pathologies of the cardiovascular system, which quite often leads to heart attacks
If these symptoms occur, you need to see a doctor and get a referral for laboratory tests. If diabetes is suspected, a set of tests is prescribed to determine the level of sugar in the blood and urine, as well as other indicators.
Blood tests for diabetes
Blood test is the main method for determining diabetes mellitus. There are 2 samples of material: on an empty stomach, strictly in the morning hours, and after meals. Each analysis has its own purpose. Additionally, it is recommended to donate blood to determine the level of glycated hemoglobin, fructosamine and general indicators.
Glucose test
The main blood test to determine diabetes mellitus is taken on an empty stomach, after 8-14 hours of fasting. On the eve of the study, sugar-containing foods are excluded from the diet. But don’t stick to a special diet. The purpose of the study is to determine the presence of the “morning dawn” syndrome, in which an increase in glucose levels occurs between 4 and 7 am. The glucose rate depends on the type of blood being tested:
- from a vein (venous blood) – up to 6.1 mmol / l;
- from a finger (capillary blood) – up to 5.5 mmol / l.
The most reliable is the result obtained when conducting a blood test taken from a vein. Although in many municipal clinics, material is taken from the finger.
Based on the results obtained, the presence or absence of diabetes is determined.
| Diagnosis | Venous blood glucose | Capillary blood glucose |
| Normal, no diabetes | up to 6.1 mmol / l | up to 5.7 mmol / l |
| Impaired glucose tolerance (prediabetes) | from 6.1 to 7 mmol / l | from 5.7 to 6.1 mmol / l |
| Diabetes | from 7 mmol / l | from 6.1 mmol / l |
But a single blood test does not make a diagnosis. If the patient has a blood sugar level above normal, then additional studies are prescribed.
Glucose tolerance test
The second type of blood test is a glucose tolerance test. It is performed to detect sudden surges in sugar after eating, which also indicates diabetes. Preparation for the test is similar – refusal to eat for 8-14 hours, exclusion of the diet of sugar-containing products on the eve of the study. On the day of the analysis, do not play sports and smoke. The first blood sample is taken on an empty stomach. Next, the patient is given a drink of 75 grams. glucose dissolved in water. In some hospitals, it is allowed to replace a solution of 100 grams. chocolate. An hour later and then another hour later, material is taken for research. Interpretation of the results is carried out 2 hours after the study.
| Diagnosis | Capillary blood result | Venous blood result |
| Norm | up to 6.7 mmol / l | up to 7.8 mmol / l |
| Impaired glucose tolerance (prediabetes) | from 6.7 to 10 mmol / l | from 7.8 to 11.1 mmol / l |
| Diabetes | above 10 mmol / l | above 11.1 mmol / l |
It should be borne in mind that during pregnancy a slight deviation from these norms is allowed. But such women are necessarily observed by an endocrinologist.
Many patients have high fasting glucose levels, and the glucose tolerance test results in normal sugar levels. In this case, the blood test must be repeated after 2-3 weeks or undergo an additional examination.
A glucose tolerance test is performed to determine the C-peptide. Normally, before exercise it is 0.5-3 ng / ml, after taking water with glucose – 2.5-15 ng / ml. Deviation from the norm in any direction will allow you to confirm or deny the diagnosis.
Analysis for glycated hemoglobin
A blood test for glycated hemoglobin is required 2 times a year for non-insulin dependent diabetes and 4 times a year for insulin-dependent diabetes. This research method is aimed at determining the average sugar level over the past 3 months. Previously, this type of blood test was used only to determine the quality of the prescribed therapy. If there is an increase in glucose above the prescribed norm, then the treatment is revised. In the past few years, glycated hemoglobin testing has been used to diagnose diabetes mellitus. You can take it at any time of the day, no food restrictions are required. The result is evaluated in venous blood. Medical report is called HbA1c. In a healthy person, it does not exceed 6%. If the value is greater, then the patient is assigned an additional examination.
Analysis for fructosamine
Another blood test is done to determine the level of fructosamine. In essence, it is similar to the test for glycated hemoglobin, but a shorter period is taken into account – the last 2-3 weeks. Fructosamine is a protein-glucose compound that is a marker of average glucose levels over the past 2-3 weeks. This analysis allows you to establish diabetes mellitus and determine the correctness of the treatment. Indicators are normal:
- women – from 161 to 351 μmol / l;
- men – from 118 to 282 μmol / l.
An analysis for fructosamine must be passed in order to establish complications of diabetes mellitus. If its level is higher than normal, then this indicates kidney problems and an overactive thyroid gland. With a significant decrease in the level of fructosamine, hypothyroidism and the development of diabetic nephropathy are suspected.
The analysis for fructosamine is not basic. This is an additional research method aimed at preventing dangerous complications.
General blood analysis
A general blood test (CBC) is prescribed in order to obtain quantitative indicators of blood components. This is necessary to assess the general condition of the body, to identify possible complications. KLA is performed for any type of diabetes and is one of the main types of research. The study evaluates the following indicators:
- Hemoglobin. The norm is 130 g / l for men and 120 g / l for women. With a significant deviation from the indicated figure, anemia is diagnosed, indicating internal bleeding and diseases of the hematopoietic system. It is possible that diabetes mellitus was the cause of the pathology. If hemoglobin is higher than normal, then this indicates a lack of fluid in the body.
- Platelets. Normally, in an adult, their number is 180-320 * 10 to the 9th degree / l. Platelets are responsible for blood clotting. And if there are few of them in the blood, then the risk of bleeding increases, which is possible with any type of diabetes and with normal platelet counts.
- Leukocytes. Normally, in a healthy person – 4-9 * 10 to the 9th degree / l. Exceeding the norm of this indicator indicates inflammatory processes.
- ESR. For men, the norm is from 2 to 10 mm / h, for women – from 2 to 15 mm / h. At higher rates, additional kidney examination is required.
Deviations from the norm do not always indicate the presence of diseases. Often the reason is a recent acute respiratory viral infection, stress, increased physical activity, and taking certain types of drugs.
Blood chemistry
Blood biochemistry is carried out to identify diseases associated with diabetes mellitus. The material is collected from a vein, strictly on an empty stomach. The following indicators are investigated:
- Cholesterol. Normally, it is from 3 to 5.2 mmol / l. With an increase in cholesterol levels, the risk of thrombosis increases, which is especially true for people with thick blood.
- Triglycerides. Normal from 0 to 2.25 mmol / l. People with insulin-dependent diabetes have an increase in these indicators. If the level is 2 or more times higher than the norm, then additional therapy is required to prevent cardiovascular diseases.
- Lipoproteins. They are classified into two types: high density (HDL) and low (LDL) density. The norm of HDL is from 0 to 2.6 mmol / L, and LDL is up to 1 mmol / L. In the first type of diabetes, lipoprotein changes are rare. If there is a deviation from the norm in T2DM, then this indicates an incorrectly chosen treatment tactics.
- Creatinine. Normally, in men from 43 to 111 mmol / l, in women – from 43 to 104 mmol / l. If there is a decrease in creatinine levels, then you need to get tested for kidney disease.
- Pancreatic peptide. Normal – from 12 to 13.9 mmol / l. With diabetes mellitus, a decrease in the level is noted. The main function of the peptide is to control the production of pancreatic juice for the breakdown of food.
The listed indicators help the doctor to confirm the patient’s diabetes mellitus and assess the state of the body. It is very important to timely identify pathologies of the kidneys, heart, blood vessels and infectious processes that accompany diabetes mellitus.
Urine analysis for diabetes
To determine diabetes mellitus and to control its course, urine tests are carried out. A general analysis is submitted every six months for the timely detection of diseases. During the study of the general analysis of urine, the following indicators are important:
- Color – in diabetes mellitus, the urine is clear, which is associated with frequent emptying of the bladder. When insulin is received, the color is normalized.
- Smell – with elevated glucose levels, it is sweetish.
- Specific gravity of urine is normal from 1012 to 1022 g / l. Exceeding this indicator indicates diabetes.
- Acidity – normal from 4 to 7 pH. An increase in acidity occurs in both types of diabetes.
- Protein is normal up to 0.33 g / l, increased in diabetics.
- Sugar – a healthy person lacks or has a small amount. With diabetes of the first and second types, it rises to 10 mmol / l or more.
- Ketone bodies are an important indicator, which in a healthy person is equal to 0. In diabetes, acetone in urine indicates serious abnormalities that require immediate medical attention.
- Leukocytes – present in small numbers (up to 6). If there are more of them, then additional diagnostics of the kidneys is carried out for complications.
A urine test for microalbuminuria is mandatory. This is the only way to determine the onset of nephropathy, a serious kidney disease. For diagnosis, morning or daily urine is required. MAU norm is 30 mg / day. If the indicator is higher, then the patient should be monitored by a nephrologist.
Tests for latent diabetes
Latent diabetes is a latent form of the disease that does not have pronounced symptoms. It is diagnosed quite often, but it is difficult to identify it due to the absence of clinical signs. To detect latent diabetes, a stress blood test is done. A glucose tolerance test is the only way to detect latent disease and immediately begin treatment, avoiding complications. With a latent type of diabetes, sugar tends to rise after eating, and on an empty stomach remains normal. And in order to diagnose the disease, the material is taken from the patient two times:
- On an empty stomach, 8-12 hours after the last meal.
- 1 or 2 hours after consuming a sweet product or glucose dissolved in water.
In a healthy person, sugar values remain normal, since the body quickly normalizes blood glucose. With small deviations, prediabetes is diagnosed, with high values - diabetes.
Tests for diabetes insipidus
Diabetes insipidus is characterized by symptoms of diabetes mellitus, but blood glucose remains within the normal range. To determine the disease, you need to undergo laboratory tests of blood and urine. What indicators are needed:
- glucose level – remains normal in diabetes insipidus;
- urine density – low, below 1005 g / l;
- the osmolarity of urine is below 300;
- hemoglobin in blood – high, more than 164 g / l.
If the patient has a history of diabetes symptoms, while blood tests show the norm of glucose, then a diagnosis of diabetes insipidus is made.
Tests for type 1 diabetes
In the first type of diabetes, an examination and consultation with a doctor is required every 3-4 months. This is necessary to determine the correctness of treatment, to identify pathologies at an early stage.
It is not difficult to diagnose the first type of diabetes – this form develops rapidly and has pronounced symptoms. The patient is not overweight, and close relatives were diagnosed with type 1 diabetes.
What tests need to be taken to control the state of the body:
- general and biochemical blood test – every 4-6 months;
- glucose tolerance test – every 3-4 months;
- general urine analysis, acetone test – every 3-5 months.
With a stable condition of the patient and a young age, the frequency of taking blood and urine tests is 5-6 months. In children, the elderly and pregnant women, the diagnosis is carried out every 2-3 months. Self-diagnostics are carried out regularly – measurement of blood sugar and ketones in urine with test strips.
Tests for type 2 diabetes
With a non-insulin-dependent type of diabetes, tests are taken at a different frequency:
- general analysis of blood and urine – 2 times a year;
- glucose tolerance test – 2 times a year.
It is important to monitor cholesterol levels by blood tests if the patient is obese.
Immunological and hormonal studies
To clarify the diagnosis, additional immunological and hormonal studies are carried out:
- determination of insulin levels – the norm is from 15 to 180 mmol / l. If the level is lower, then this is the first type of diabetes, if higher, then the second;
- antibodies to beta cells are detected for early diagnosis of DM and predisposition to DM1;
- antibodies to insulin are found in type 1 diabetes;
- antibodies to GAD determine the propensity for diabetes and make it possible to diagnose the disease 3-5 years before its recurrence.
These blood tests are done to determine the predisposition to diabetes and help determine the type of diabetes.
Blood and urine tests are an obligatory method of regular examination of patients with diabetes mellitus and diabetes insipidus. They are necessary to monitor the state of the body and diagnose complications at an early stage.