Diabetes is a disorder in which the body does not produce or properly use insulin. Insulin is a hormone that is
needed to convert sugar, starches and other food into energy needed for your daily life.
The cause of diabetes
said to be through genetics and environmental factors, such as obesity and lack of exercise.
Diabetes exacts a high toll worldwide. Diabetes is said to be the sixth leading cause of death in the US and
the leading cause of kidney disease also called end-stage renal disease -ESRD, blindness (due to
retinopathy) and amputations. Diabetes also carries an increased risk for heart attacks, strokes, poor
circulation and nerve damage. All of these problems result from uncontrolled blood glucose and are made
worse by changes in the fats in the blood stream.
Additional risk factors are high blood pressure and smoking. People with diabetes need to control all of these risk factors and monitor continously through doctors and medical attention to prevent damage to vital organs.
It is very important to have routine laboratory tests so your doctor can monitor the results. These tests
are conducted using a sample of a person’s blood and urine. The blood tests include A1C, LDL cholesterol,
HDL cholesterol and triglyceride levels. The urine test is a special test for protein in the urine called albumin.
This test will detect the earliest signs of kidney disease.
Question: What is A1C test?
Answer: This blood test measures the average of your blood
glucose over three months and is an excellent way to assess
your overall blood glucose control.
Your A1C levels should have been measured when you were first
diagnosed with diabetes or when you began a treatment
program for your diabetes.
After the initial test, your A1C levels sould be tested every three to six months.
This A1C testing does not replace your daily blood glucose tests.
Question: What is a microalbumin test?
Answer: A microalbumin test evaluates your urine for the
presence of a protein called albumin. Albumin is normally
found in the blood and is filtered by the kidneys. When the
kidneys are working properly, very little albumin is present in
the urine. However, when the kidneys are damaged by
diabetes, more albumin may leak into the urine. This
condition is called microalbuminuria. Microalbuminuria is an
early sign of kidney damage, or nephropathy, a common and
serious complication of diabetes.
Its recommended that people
diagnosed with type 2 diabetes be tested for
microalbuminuria at the time they are diagnosed and every
year thereafter; people with type 1 diabetes should be tested
five years after diagnosis and every year thereafter.
Microalbuminuria is usually managed by improving blood
glucose control, reducing blood pressure and modifying the
diet.
If blood glucose levels remain high and early kidney damage
is not treated, larger amounts of albumin may leak into the
urine. This condition is called macroalbuminuria and this can
indicate serious kidney damage that can lead to kidney failure.
Some drugs in a category called ACE inhibitors can delay
progression of kidney damage. If you have protein in your
urine, talk to your doctor to know more.
Question: Which fats in the blood stream are important
to monitor?
Answer: The three different fats that are the most closely
watched are LDL cholesterol, HDL cholesterol and
triglycerides.
LDL cholesterol, also known as the “bad” cholesterol, can
block your blood vessels. Blocked blood vessels increase your
risk of having a stroke or heart attack. Your LDL cholesterol
should be less than 100 mg/dl.
HDL cholesterol is known as the “good” cholesterol. HDL
cholesterol prevents your blood vessels from becoming
blocked by helping remove fatty deposits on the inside of
your blood vessels. High HDL cholesterol leads to a healthier
heart! Your HDL cholesterol should be more than 40 mg/dl.
If it can be made higher than 50 mg/dl, that is even better
for your heart!
Triglycerides are like LDL cholesterol in that they increase
your risk of having a stroke or heart attack. Your triglyceride
levels should be less than 150 mg/dl.
Question: How often should one get LDL cholesterol, HDL cholesterol and triglyceride levels checked?
Answer: LDL cholesterol, HDL cholesterol and triglyceride levels should be checked at least once a year.
If the numbers are not controlled to ideal levels, your
doctor will institute treatment and recheck the levels every
several months until they are controlled.
Question: What is blood pressure?
Answer: As your heart beats, it pumps blood to the arteries.
The pressure of blood against the walls of the arteries is
called blood pressure. When the pressure in the arteries is
higher than normal, it is called hypertension or high blood
pressure.
When you have high blood pressure, your heart has to work
harder and your arteries are under greater pressure. Your
heart and arteries may be weakened if you have high blood
pressure over a long period of time. The goal is to be less
than 130/80 mm/Hg.
Question: What about high blood pressure and diabetes?
Answer: Diabetes and high blood pressure increase your risk
for developing heart disease, stroke, kidney problems, nerve
disease and eye problems. Your doctor should check your
blood pressure at every visit to make sure your blood
pressure is controlled. If you have diabetes, keeping your
blood pressure controlled and below 130/80 mm/Hg will
help prevent problems. Medication is often used if salt
restriction, weight loss and exercise do not reduce your blood
pressure. Many people with diabetes will benefit from a
special medication called an ACE inhibitor, which is an oral
medicine that lowers blood pressure.
Blood Diseases 
