Suspected Diabetic Evaluation Panel

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Adiponectin

Also known as: C-Terminal Insulin, Connecting peptide insulin, CPeptide, Insulin C-peptide, Proinsulin C-peptide

C-Peptide

Also known as: A1c, Glycated Hemoglobin, Glycohemoglobin, Glycosylated Hemoglobin, HA1c, HbA1c, Hemoglobin A1c, Hemoglobin A1c HgbA1C, Hgb A1c

Hemoglobin A1c

The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also often called glycosylated) hemoglobin A1c. Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin, but the predominant form – about 95-98% – is hemoglobin A. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A. The hemoglobin molecules with attached glucose are called glycated hemoglobin. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell – normally about 120 days. The predominant form of glycated hemoglobin is referred to as HbA1c or A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place. This test is used to monitor treatment in someone who has been diagnosed with diabetes. It helps to evaluate how well their glucose levels have been controlled by treatment over time. This test may be used to screen for and diagnose diabetes or risk of developing diabetes. In 2010, clinical practice guidelines from the American Diabetes Association (ADA) stated that A1c may be added to fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) as an option for diabetes screening and diagnosis. For monitoring purposes, an A1c of less than 7% indicates good glucose control and a lower risk of diabetic complications for the majority of diabetics. However, in 2012, the ADA and the European Association for the Study of Diabetes (EASD) issued a position statement recommending that the management of glucose control in type 2 diabetes be more "patient-centered." Data from recent studies have shown that low blood sugar (hypoglycemia) can cause complications and that people with risk of severe hypoglycemia, underlying health conditions, complications, and a limited life expectancy do not necessarily benefit from having a stringent goal of less than 7% for their A1c. The statement recommends that people work closely with their doctor to select a goal that reflects each person's individual health status and that balances risks and benefits.

Also known as: Insulin (fasting)

Insulin

Insulin is a hormone that is produced and stored in the beta cells of the pancreas. It is vital for the transportation and storage of glucose at the cellular level, helps regulate blood glucose levels, and has a role in lipid metabolism. When blood glucose levels rise after a meal, insulin is released to allow glucose to move into tissue cells, especially muscle and adipose (fat) cells, where is it is used for energy production. Insulin then prompts the liver to either store the remaining excess blood glucose as glycogen for short-term energy storage and/or to use it to produce fatty acids. The fatty acids are eventually used by adipose tissue to synthesize triglycerides to form the basis of a longer term, more concentrated form of energy storage. Without insulin, glucose cannot reach most of the body's cells. Without glucose, the cells starve and blood glucose levels rise to unhealthy levels. This can cause disturbances in normal metabolic processes that result in various disorders, including kidney disease, cardiovascular disease, and vision and neurological problems. Thus, diabetes, a disorder associated with decreased insulin effects, is eventually a life-threatening condition.

Proinsulin

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The Suspected Diabetic Evaluation Panel panel contains 5 tests with 5 biomarkers.

The Suspected Diabetic Evaluation Panel is a comprehensive set of tests designed to assess various factors that contribute to the diagnosis and management of diabetes. Each component of the panel provides crucial information about the individual's metabolic state and insulin function:

  1. Adiponectin: This hormone is produced by adipose tissue and plays a role in regulating glucose levels and fatty acid breakdown. Low levels of adiponectin are associated with insulin resistance, commonly seen in type 2 diabetes. Testing for adiponectin can help assess the risk and severity of diabetes.

  2. C-Peptide: This test measures the level of C-peptide in the blood, which is a byproduct of insulin production. It helps to distinguish between insulin produced by the body and insulin injected as medication. High or normal levels can indicate type 2 diabetes, where insulin is produced but not effectively used by the body.

  3. Hemoglobin A1c (HgbA1C): This test measures the average blood sugar levels over the past three months by assessing the percentage of glycated hemoglobin. It is a key indicator of long-term glucose control and is used to diagnose and monitor diabetes.

  4. Insulin: Measuring insulin levels helps evaluate insulin production by the pancreas. This test is particularly useful in understanding various types of diabetes and can help in distinguishing between type 1 (low or no insulin production) and type 2 diabetes (normal or high insulin levels due to resistance).

  5. Proinsulin: Proinsulin is a precursor to insulin. High levels of proinsulin can indicate a strain on beta cells in the pancreas as they try to produce more insulin, often seen in the early stages of type 2 diabetes. This test can be useful in detecting beta-cell dysfunction before full-blown diabetes develops.

This panel collectively provides a detailed picture of an individual’s insulin production and action, glucose control, and risk factors associated with diabetes, aiding in timely diagnosis and effective management.

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