LABORATORY DIAGNOSIS

Tests For Type 1 and Type 2 Diabetes

BLOOD CHEMISTRY

 Glycated Hemoglobin (A1C) Test

o Measures the average blood sugar level over the past two to three months
o This blood test doesn’t require fasting
o It measures the percentage of blood sugar attached o hemoglobin, the oxygen-carrying
protein in red blood cells
o The higher your blood sugar levels, the more hemoglobin you’ll have with sugar
attached. An A1C level of 6.5% or higher on two separate tests indicates that you have
diabetes. An A1C between 5.7% and 6.4% indicates pre-diabetes (A condition in which
blood sugar is high but not high enough to be type 2 diabetes). Below 5.7 is considered
normal
 Random Blood Sugar Test
o Blood samples are taken at a random time.
o A random blood sugar level of 200 mg/dL or higher suggests diabetes
 Fasting Blood Sugar Test
o Blood samples are taken after overnight fasting (at least 10-12 hrs)
o A fasting blood sugar level of <99 mg/dL (<5.6mmol/L) is normal.
o A fasting blood sugar level from 100 – 125 mg/dL (5.6 to 6.9 mmol/L) indicates
prediabetes
o A fasting blood sugar level >126 mg/dL (>7 mmol/L) suggests diabetes.
 Oral Glucose Tolerance Test
o The glucose tolerance test, also known as the oral glucose tolerance test, measures your
body's response to sugar (glucose).
o For this test, a fasting blood sugar level is measured. Then you’ll drink a liquid that
contains sugar and have your blood sugar level checked for 1 hour, 2 hours, and possibly
3 hours afterward. At 2 hours, a blood sugar level of 140 mg/dL or lower is considered
normal, 140 to 199 mg/dL indicates you have prediabetes, and 200 mg/dL or higher
indicates you have diabetes.

URINALYSIS

 Urine analysis aren’t used to diagnose diabetes. However, they may be used to monitor a
person’s levels of ketones and glucose in urine. Sometimes they’re used to ensure diabetes is
being managed properly.
 It is also often used to classify type 1 diabetes from type 2. In type 1 diabetes, the body may also
begin to burn fat for energy instead of glucose, thus producing chemicals called ketones which is
toxic in large amounts. If ketones are present in moderate to large amounts in your urine, this
could indicate your body is not making enough insulin to break down glucose for energy.
IMMUNOASSAYS

 In diabetology, immunoassays are widely used to determine HbA1c, C-peptide, insulin, and
autoantibodies to beta cell proteins, which are essential biomarkers for the diagnosis and
classification of diabetes mellitus. Diabetes Autoantibody Panel checks for substances called
antibodies such as Islet cell cytoplasmic autoantibodies (ICA), Glutamic acid decarboxylase
autoantibodies (GADA), Insulinoma-associated-2 autoantibodies (IA-2A) and Insulin
autoantibodies (IAA). If you have some combination of these antibodies in high levels, it could
mean you have type 1 diabetes. Or it could mean you are at risk of developing it. People with
type 2 diabetes don't have these antibodies, so the test is also useful to tell which type of
diabetes a person has.

Tests for Gestational Diabetes Mellitus

 Initial Glucose Challenge Test

o In this test, a blood sample is taken 1 hour after drinking a liquid containing glucose.
o You do not need to fast for this test.
o If the blood glucose level is too high—135 mg/dL to 140 mg/dL or higher—a follow-up
oral glucose tolerance test while fasting is needed.

REFERENCE

https://www.cdc.gov/diabetes/basics/getting-tested.html#:~:text=The%20A1C%20test%20measures
%20your,higher%20indicates%20you%20have%20diabetes.

https://www.slideshare.net/varinderkumar62/diabetes-mellitus-introductiontypes-of-diabetes-
mellitus?fbclid=IwAR2TTTJvEoxcaK2hRGFRHqulj04r9bV9z6SJ9N0u5-btNng10dLGZVVTQ5M

https://www.healthline.com/health/diabetes-tests#blood-tests

https://www.sciencedirect.com/science/article/pii/S0734975019300345#:~:text=In%20diabetology%2C
%20immunoassays%20are%20widely,and%20classification%20of%20diabetes%20mellitus.

https://www.urmc.rochester.edu/encyclopedia/content.aspx?
ContentTypeID=167&ContentID=diabetes_autoantibody