Additional lab testing

reefedjib · #1 (**permalink**) 08-02-2009, 08:25 AM

I am a Type 2, reading Using Insulin. They list some additional lab tests that can be done for both Type1 and Type 2. My question is whether it is useful for me to request some of these additional tests. They include:

- Ketones (for Type 1 and insulin dependent diabetes) I am insulin dependent, so maybe this would be useful.
- C-peptide (all) This is the one I am really wondering about. How much insulin is my pancreas producing?
- Uric acid (Type 2)

jps · #2 (**permalink**) 08-02-2009, 10:34 AM

Ketones are part of a routine urinalysis. You should probably have that done anyway because a urinalysis can detect protein in your urine (usually an indicator of some degree of kidney problems, but could be due to strenous exercise). A blood ketone (called acetone) isn't at all necessary as part of a routine check up - it only becomes important when you are in ER for DKA.

C-Peptide, I concur. Get that ordered.

Uric Acid - I don't understand the need for this one. Unless I'm mistaken - uric acid, I don't see where it could be of any benefit for a T2... Uric acid will be elevated in conditions such as gout and increased white blood cell destruction (chemotherapy, some disease processes).

Since many T2's have lipid problems as part of metabolic syndrome, it's probably a really good idea to get a complete lipid panel done.

You'll want a CMP (aka comprehensive metabolic panel or Chem panel). That will give you your Creatinine and BUN along with an eGFR which tell you about your overall kidney health. It will also give you your AST, ALT, ALP which helps show if you have a fatty liver and/or are being overaffected by any meds.

I think for a checkup, T2's should get CMP, HbA1c, Lipid Panel, urinalysis at the minimum.

reefedjib · #3 (**permalink**) 08-02-2009, 10:49 AM

Quote:

Originally Posted by jps

I think for a checkup, T2's should get CMP, HbA1c, Lipid Panel, urinalysis at the minimum.

This makes total sense. You left off the c-Peptide test, though. I am already getting the CMP, HbA1c, Lipid Panel done. I'll ask her to add the urinalysis and c-Peptide.

Thanks!

butterflykisses · #4 (**permalink**) 08-02-2009, 11:33 AM

Ketones are present in urine when your body is using fat as a main fuel source. Ketones present might mean someone is not making enough insulin so their bodies start using their body fat as fuel...usually seen in Type 1's, aka, insulin dependent, but it's not unheard of that a Type 2 might present with ketones. However, someone who is low carbing could be spilling ketones and it's not a problem. Atkins wants you to spill ketones (or at least "back in they day") because it's a sign that they're following the diet correctly, using fat as the main fuel source. Someone who is dropping weight quickly (would like to see those Biggest Losers ketone levels) will most likely be spilling ketones. I guess my point is, ketone presence doesn't necessarily mean that there's a problem UNLESS you're not making enough insulin and your glucose in that case would also be high. (DKA)

foxl · #5 (**permalink**) 08-02-2009, 11:41 AM

If you have any reason to suspect autoimmune disease (which may be prior, concurrent, or subsequent to IR according to some people), you could ask for antibody testing. It is costly and many times they are not willing to request it.

GAD-65 is the most commonly found, and ICA (Anti-Islet Cell), and Insulin antibodies.