Diabetes Health

• Comprehensive Metabolic Panel (CMP) [ 10231 ]
• Glucose (included in CMP)
• Hemoglobin A1c (HgbA1C) [ 496 ]

• CBC (includes Differential and Platelets) [ 6399 ]
• Comprehensive Metabolic Panel (CMP) [ 10231 ]
• Glucose (included in CMP)
• Hemoglobin A1c (HgbA1C) [ 496 ]
• Lipid Panel [ 7600 ]
• Microalbumin, Random Urine with Creatinine [ 6517 ]

• C-Reactive Protein (CRP) [ 4420 ]
• CBC (includes Differential and Platelets) [ 6399 ]
• Comprehensive Metabolic Panel (CMP) [ 10231 ]
• Glucose (included in CMP)
• Hemoglobin A1c (HgbA1C) [ 496 ]
• Insulin [ 561 ]
• Lipid Panel [ 7600 ]
• Microalbumin, Random Urine with Creatinine [ 6517 ]

• C-Reactive Protein (CRP) [ 4420 ]
• CBC (includes Differential and Platelets) [ 6399 ]
• Comprehensive Metabolic Panel (CMP) [ 10231 ]
• Glucose (included in CMP)
• Glucose Tolerance Test, 2 Specimens (75g) [ 35181 ]
• Hemoglobin A1c (HgbA1C) [ 496 ]
• Insulin [ 561 ]
• Insulin Response to Glucose, 2 Specimens [ 6697 ]
• Lipid Panel [ 7600 ]
• Microalbumin, Random Urine with Creatinine [ 6517 ]

• Glutamic Acid Decarboxylase-65 Antibody [ 34878 ]

• Adiponectin [ 15060 ]
• Glutamic Acid Decarboxylase-65 Antibody [ 34878 ]
• Proinsulin [ 760 ]

• Adiponectin [ 15060 ]
• C-Peptide [ 372 ]
• Fructosamine [ 8340 ]
• Glutamic Acid Decarboxylase-65 Antibody [ 34878 ]
• Proinsulin [ 760 ]
• Urinalysis (UA), Complete [ 5463 ]
   

• Adiponectin [ 15060 ]
• Apolipoprotein A1 + B [ 7018 ]
• C-Peptide [ 372 ]
• Fructosamine [ 8340 ]
• Glutamic Acid Decarboxylase-65 Antibody [ 34878 ]
• IA-2 Antibody [ 36177 ]
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™ [ 91604 ]
• Proinsulin [ 760 ]
• Urinalysis (UA), Complete [ 5463 ]
   

Identifying patients who have metabolic syndrome and who are thus at higher risk of diabetes, coronary heart disease or stroke. Identifying patients who are insulin resistant (fasting insulin at or above the 75th percentile) and who are thus at higher risk of diabetes, coronary heart disease, stroke, or liver disease. Monitoring of risk factors and insulin levels after life style change, medication use, or both.

Cardio IQ® Diabetes and ASCVD Risk Panel with Scores - Includes:  Cardio IQ® Glucose; Cardio IQ® Hemoglobin A1c; Cardio IQ® Cholesterol, Total; Cardio IQ® HDL Cholesterol; Cardio IQ® Triglycerides; Cardio IQ® Non-HDL and Calculated Components; Cardio IQ® Risks and Personal Factors

If Triglyceride is >400 mg/dL, Cardio IQ® Direct LDL will be performed at an additional charge (CPT code(s): 83721).

Clinical Significance

The increasing prevalence of obesity has led to an epidemic of diabetes mellitus and related complications, including ASCVD. Prediction of the risk of ASCVD and of developing diabetes in the Cardio IQ® lab report will simplify and improve the communication of those risks to patients.

This panel provides the 10-year and lifetime risk of ASCVD events and the 8-year risk of developing diabetes. The lipid panel results will aid in the assessment of ASCVD. Assessment of 10-year risk of a first atherosclerotic cardiovascular (ASCVD) event is recommended by the 2013 ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. These guidelines recommend initiating statin therapy based on 10-year ASCVD risk score. Assessment of 8-year risk of developing diabetes mellitus is based on laboratory test results with anthropomorphic data and family history. This algorithm was developed in the Framingham cohort, and is intended to aid in the identification of patients at risk for developing diabetes, permitting pharmacological or lifestyle interventions.

IMPORTANT: For risk calculations to be performed, the following patient-specific information must be provided and recorded at the time of specimen collection:

• Age: Years 
• Gender: M (for male) or F (for female) 
• Height Feet: Feet 
• Height Inches: Inches 
• Weight: lbs 
• Race-African American: Y (for yes) or N (for no) 
• Systolic Blood Pressure: mmHg
• Diastolic Blood Pressure: mmHg
• Treatment for High B.P.: Y (for yes) or N (for no) 
• Diabetes Status: Y (for yes) or N (for no)
• Parental History of Diab: Y (for yes) or N (for no) 
• Smoking Status: Y (for Yes) or N (for no)

Cardio IQ® Diabetes Risk Panel with Score - 

Includes
Cardio IQ® Glucose; Cardio IQ® Hemoglobin A1c; Cardio IQ® Cholesterol, Total; Cardio IQ® HDL Cholesterol; Cardio IQ® Triglycerides; Cardio IQ® Non-HDL and Calculated Components; Cardio IQ® 8 Year Diabetes Risk

If Triglyceride is >400 mg/dL, Cardio IQ® Direct LDL will be performed at an additional charge (CPT code(s): 83721).

Clinical Significance

Permit the assessment of serum glucose levels and lipid levels and the prediction of the 8-year future risk of developing diabetes mellitus in patients without diabetes mellitus.

• Assess risk for developing type 2 diabetes mellitus
• Identify lifestyle interventions and/or pharmacotherapy
• This test provides an 8-year risk of developing type 2 diabetes

Type 1 diabetes mellitus is defined as a deficiency of insulin secretion. Type 2 diabetes, which accounts for greater than 90% of all diabetes cases, is caused by a combination of insulin resistance and an inadequate compensatory insulin secretion.

Type 2 diabetes frequently goes undiagnosed, because it has no classic symptoms of diabetes and it progresses slowly from a pre-diabetic state. 

The U.S. Centers for Disease Control and Prevention estimates that 37% of individuals that are greater than 20 years old and approximately  half of those are greater than 65 years old have pre-diabetes. These individuals are at high risk for progression to type 2 diabetes and are candidates for preventive therapy that include lifestyle modification, such as weight  loss, increased physical activity, and medication.

IMPORTANT: For risk calculations to be performed, the following patient-specific information must be provided and recorded at the time of specimen collection:

• Age: Years 
• Gender: M (for male) or F (for female) 
• Height Feet: Feet 
• Height Inches: Inches 
• Weight: lbs 
• Race-African American: Y (for yes) or N (for no) 
• Systolic Blood Pressure: mmHg
• Diastolic Blood Pressure: mmHg
• Treatment for High B.P.: Y (for yes) or N (for no) 
• Diabetes Status: Y (for yes) or N (for no)
• Parental History of Diab: Y (for yes) or N (for no) 
• Smoking Status: Y (for Yes) or N (for no)

Diabetes Risk Panel with Score

• Assess risk for developing type 2 diabetes mellitus
• Identify lifestyle interventions and/or pharmacotherapy
• This test provides an 8-year risk of developing type 2 diabetes
Type 1 diabetes mellitus is defined as a deficiency of insulin secretion. Type 2 diabetes, which accounts for greater than 90% of all diabetes cases, is caused by a combination of insulin resistance and an inadequate compensatory insulin secretion.

Type 2 diabetes frequently goes undiagnosed, because it has no classic symptoms of diabetes and it progresses slowly from a pre-diabetic state. 
The U.S. Centers for Disease Control and Prevention estimates that 37% of individuals that are greater than 20 years old and approximately  half of those are greater than 65 years old have pre-diabetes. These individuals are at high risk for progression to type 2 diabetes and are candidates for preventive therapy that include lifestyle modification, such as weight  loss, increased physical activity, and medication.

IMPORTANT: For risk calculations to be performed, the following patient-specific information must be provided and recorded at the time of specimen collection:

• Age: Years 
• Gender: M (for male) or F (for female) 
• Height Feet: Feet 
• Height Inches: Inches 
• Weight: lbs 
• Race-African American: Y (for yes) or N (for no) 
• Systolic Blood Pressure: mmHg
• Diastolic Blood Pressure: mmHg
• Treatment for High B.P.: Y (for yes) or N (for no) 
• Diabetes Status: Y (for yes) or N (for no)
• Parental History of Diab: Y (for yes) or N (for no) 
• Smoking Status: Y (for Yes) or N (for no)

 

This panel is designed for individuals diagnosed as having diabetes mellitus whose kidney disease has advanced to Stage 3/4 impairment. The panel affords the opportunity to assess electrolytes, phosphorus, serum creatinine/eGFR, hemoglobin, microalbumin, parathyroid hormone, calcium, and vitamin D. The grouping of these tests, readily identifiable as elements that adhere to guideline recommendations, is intended to facilitate the ready adherence to professional society clinical practice guidelines. Components of the testing related to the Management of CKD in diabetes, as outlined in the Standards of Medical Care in Diabetes 2013. These recommendations are in broad agreement with those published by the National Kidney Foundation and the American Association of Clinical Endocrinologists.

Description: Hemoglobin A1c is the protein Hemoglobin found in red blood cells, but with glucose attached to it. Hemoglobin A1c is used to check for and monitor diabetes as it shows average blood glucose levels over the past 2 to 3 months.

Also Known As: A1c Test, HbA1c Test, Glycohemoglobin Test, Glycated Hemoglobin Test, Glycosylated Hemoglobin Test, HbA1c Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Hemoglobin A1c test ordered?

A1c may be requested as part of a routine physical examination or when a practitioner suspects a patient of having diabetes due to characteristic signs or symptoms of high blood sugar, such as:

• Increased thirst and fluid intake
• Increased urination
• Increase in hunger
• Fatigue
• Vision is hazy
• Infections that take a long time to heal

Adults who are overweight and have the following additional risk factors may consider doing the A1c test:

• Physically inactive
• Diabetes in a first-degree relative
• Race/ethnicity that is at high risk such as African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders
• Blood pressure that is high
• A lipid profile that is abnormal.
• Polycystic ovarian syndrome 
• Cardiovascular disease 
• Insulin resistance and other conditions links to insulin resistance

People who have not been diagnosed with diabetes but have been assessed to be at an increased risk of developing diabetes should have their A1c levels tested at least once a year.

Monitoring

The A1c test may be performed 2 to 4 times a year, depending on the type of diabetes a person has, how well their diabetes is controlled, and the healthcare provider's recommendations. If diabetics are fulfilling treatment goals and have stable glycemic control, the American Diabetes Association advises A1c testing at least twice a year. A1c may be ordered quarterly when someone is first diagnosed with diabetes or if control isn't good.

What does a Hemoglobin A1c blood test check for?

Hemoglobin A1c, often known as A1c or glycated hemoglobin, is hemoglobin that has been attached to glucose. By assessing the proportion of glycated hemoglobin, the A1c test determines the average quantity of glucose in the blood during the previous 2 to 3 months.

Hemoglobin is a protein present inside red blood cells that transports oxygen.

Glycated hemoglobin is generated in proportion to the amount of glucose in the blood. Once glucose attaches to hemoglobin, it stays there for the duration of the red blood cell's life, which is usually about 120 days. The most common kind of glycated hemoglobin is known as A1c. A1c is created on a daily basis and is gradually removed from the bloodstream as older RBCs die and younger RBCs replace them.

This test can be used to detect and diagnose diabetes, as well as the risk of developing it. According to the American Diabetes Association's standards of medical care in diabetes, diabetes can be diagnosed using either A1c or glucose.

This test can also be used to track the progress of a diabetic patient's treatment. It aids in determining how well a person's glucose levels have been controlled over time by medication. An A1c of less than 7% suggests good glucose control and a lower risk of diabetic complications for the majority of diabetics for monitoring reasons.

Lab tests often ordered with a Hemoglobin A1c test:

• Complete Blood Count
• Glucose
• Frucstosamine
• Albumin
• Comprehensive Metabolic Panel
• Microalbumin w/creatinine
• Lipid panel

Conditions where a Hemoglobin A1c test is recommended:

• Type 1 Diabetes
• Type 2 Diabetes

How does my health care provider use a Hemoglobin A1c test?

Adults can use the hemoglobin A1c test to screen for and diagnose diabetes and prediabetes.

A fasting glucose or oral glucose tolerance test should be done to screen or diagnose diabetes in these instances.

The A1c test is also used to track diabetics' glucose control over time. Diabetics strive to maintain blood glucose levels that are as close to normal as feasible. This helps to reduce the risks of consequences associated with chronically high blood sugar levels, such as progressive damage to body organs such as the kidneys, eyes, cardiovascular system, and nerves. The result of the A1c test depicts the average quantity of glucose in the blood over the previous 2-3 months. This can help diabetics and their healthcare professionals determine whether the steps they're taking to control their diabetes are working or if they need to be tweaked.

A1c is a blood test that is usually used to help newly diagnosed diabetics identify how high their uncontrolled blood glucose levels have been in the previous 2-3 months. The test may be ordered multiple times throughout the control period, and then at least twice a year after that to ensure that good control is maintained.

What does my Hemoglobin A1c test result mean?

HbA1c levels is currently reported as a percentage for monitoring glucose control, and it is suggested that most diabetics try to keep their hemoglobin A1c below 7%. The closer diabetics can keep their A1c to the therapeutic objective of less than 7% without experiencing abnormally low blood glucose, the better their diabetes is controlled. The risk of problems rises as the A1c rises.

However, a person with type 2 diabetes may have an A1c goal set by their healthcare professional. The length of time since diagnosis, the presence of other diseases as well as diabetes complications, the risk of hypoglycemia complications, life expectancy, and whether or not the person has a support system and healthcare resources readily available are all factors that may influence the goal.

For example, a person with heart disease who has had type 2 diabetes for many years without diabetic complications may have a higher A1c target set by their healthcare provider, whereas someone who is otherwise healthy and newly diagnosed may have a lower target set by their healthcare provider as long as low blood sugar is not a significant risk.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: A Urinalysis complete test is a urine test that is used to screen for, diagnose, and monitor a variety of conditions and diseases urinary tract infections and kidney disorders.

Also Known As: Urine Test, Urine Analysis Test, UA Test, urine microscopic examination Test, Urinalysis Test, Complete Urinalysis Test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

When is a Urinalysis Complete test ordered?

A urinalysis test may be ordered when a person undergoes a routine wellness examination, is admitted into a hospital, will have surgery, or is having a prenatal checkup.

When a person visits a doctor with symptoms of a urinary tract infection or another urinary system ailment, such as kidney disease, a urinalysis will almost certainly be prescribed. The following are some possible signs and symptoms:

• Pain in the abdomen
• Backache
• Urination that is painful or occurs frequently
• Urine with blood in it

Testing may also be conducted at regular intervals to track the progress of a condition.

What does a Urinalysis Complete test check for?

A urinalysis is a series of examinations done on urine that are physical, chemical, and microscopic. The tests identify and/or measure a number of elements in the urine, including cells, cellular fragments, and microbes. These elements include byproducts of healthy and unhealthy metabolism.

Urine is produced by the kidneys, two fist-sized organs located on either side of the spine near the base of the rib cage. The kidneys help the body regulate its water balance, filter wastes from the blood, and store proteins, electrolytes, and other molecules for later use. To get rid of everything unnecessary, urine travels from the kidneys to the ureters, bladder, and urethra before exiting the body. The color, amount, concentration, and content of urine will change slightly every time a person urinates due to the varied elements in urine, despite the fact that pee is normally yellow and clear.

By screening for components in the urine that aren't typically present and/or monitoring aberrant levels of specific substances, many illnesses can be caught early on. Glucose, bilirubin, protein, red and white blood cells, crystals, and germs are among examples. They could be present because of the following reasons:

• The body responds to an elevated amount of the substance in the blood by attempting to remove the excess through urine.
• There is a problem with the kidneys.
• As with bacteria and white blood cells, there is a urinary tract infection present.

Three separate phases make up a full urinalysis:

• The color and clarity of the urine are assessed using a visual examination.
• Chemical examination, which determines the concentration of urine and tests for roughly 9 chemicals that provide useful information about health and disease.
• Microscopic inspection that identifies and counts the different types of cells, casts, crystals, and other components found in urine, such as bacteria and mucus.

When abnormal results are found, or if a healthcare provider requests it, a microscopic analysis is usually performed.

It may be essential to repeat the test if the findings of a urinalysis are abnormal, and further other urine and blood tests may be needed to help establish a diagnosis, if the results are abnormal.

Lab tests often ordered with a Urinalysis Complete test:

• Complete Blood Count
• Iron Total and Total Iron binding capacity
• Hemoglobin A1c
• Lipid Panel
• CMP
• TSH
• Urine Culture
• Bilirubin Fractionated
• Glucose

Conditions where a Urinalysis Complete test is recommended:

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension
• Pregnancy
• Hematuria
• Proteinuria
• Kidney Stones

How does my health care provider use a Urinalysis Complete test?

A urinalysis is a series of tests that can diagnose a variety of disorders. It can be used to screen for and/or diagnose a variety of illnesses, including urinary tract infections, renal abnormalities, liver diseases, diabetes, and other metabolic disorders, to name a few.

Urinalysis may be used in conjunction with other tests, such as urine albumin, to monitor the progress of treatment in patients with diseases or conditions like diabetes or kidney disease.

What do my urinalysis complete test results mean?

There are numerous ways to interpret the results of a urinalysis. Unusual results are a warning sign that something isn't right and needs further testing.  To connect the urinalysis results with an individual's symptoms and clinical findings and to look for the causes of aberrant findings, other targeted tests must be done, such as a complete blood count, metabolic panel, or urine culture.

It is more likely that a problem must be addressed the higher the concentration of the atypical component, such as noticeably increased levels of protein, glucose, or red blood cells. On the other hand, the outcomes do not inform the medical professional as to what led to the finding or whether it is a transient or ongoing sickness.

A normal urinalysis does not rule out the possibility of disease. Early in a disease process, some persons will not release elevated amounts of a drug, and others will release them irregularly throughout the day, which means they could be overlooked by a single urine sample. Small amounts of substances may be undetectable in very dilute urine.

NOTE: Only measurable biomarkers will be reported.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: A Basic Metabolic Panel is a blood test used to screen for, diagnose, and monitor a variety of conditions and diseases such as diabetes and kidney disease.  

Also Known As: BMP, Chemistry Panel, Chemistry Screen, Chem 7, Chem 11, BMP Test, SMA 7, SMAC7, Basic Metabolic Test, Chem Test, Chem Panel Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred. 

When is a Basic Metabolic Panel test ordered?  

A BMP may be requested as part of a standard physical examination. 

The panel is frequently ordered in hospital emergency rooms because its components provide vital information regarding a person's renal state, electrolyte and acid/base balance, blood glucose, and calcium levels. Significant changes in these test results can suggest serious issues such as renal failure, insulin shock or diabetic coma, respiratory distress, or abnormalities in heart rhythm. 

What does a Basic Metabolic Panel blood test check for? 

The basic metabolic panel (BMP) is a 9-test panel that provides essential information to a health practitioner about a person's current metabolic status, including kidney health, blood glucose level, electrolyte and acid/base balance. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the BMP test: 

• Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

• Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. Calcium is also used for blood clot formation and the formation and maintenance of bones and teeth. 

• Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

• Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

• Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

• Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

• Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

• Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood Urea Nitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Basic Metabolic Panel test: 

• Complete Blood Count with Differential and Platelets
• Hemoglobin A1c
• Iron and Total Iron Binding Capacity
• Lipid Panel
• Insulin
• Vitamin B12 and Folate
• C-Reactive Protein

Conditions where a Basic Metabolic Panel test is recommended: 

• Diabetes 
• Kidney Disease 
• Liver Disease 

Commonly Asked Questions: 

How does my health care provider use a Basic Metabolic Panel test? 

The basic metabolic panel (BMP) is used to evaluate a person's kidney function, electrolyte, acid/base balance, and blood glucose level, all of which are linked to their metabolism. It can also be used to keep track of hospitalized patients and persons with known illnesses like hypertension and hypokalemia. 

If a health practitioner wants to track two or more separate BMP components, the full BMP might be ordered because it contains more information. Alternatively, when monitoring, the healthcare provider may order specific tests, such as a follow-up glucose, potassium, or calcium test, or an electrolyte panel to track sodium, potassium, chloride, and CO2. If a doctor needs further information, he or she can request a comprehensive metabolic panel (CMP), which is a collection of 21 tests that includes the BMP. 

What do my Basic Metabolic Panel results mean? 

The results of the tests included in the BMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. 

Out-of-range results on any of the BMP's tests can be caused by a number of things, including kidney failure, breathing issues, and diabetes-related consequences. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

The results of the BMP components can be influenced by a range of prescription and over-the-counter medicines. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide them with a thorough medical history because many other circumstances can influence how your results are interpreted. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 

Clinical Significance

Rheumatoid Arthritis Diagnostic IdentRA® Panel 2 - Early diagnosis of rheumatoid arthritis (RA), ie, diagnosis before significant joint erosion occurs, is difficult. Psoriatic arthritis can also be difficult to diagnose clinically early in the disease process, and there are no specific biomarkers. The 14-3-3η (eta) protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis. The 14-3-3η protein, used in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, may improve diagnostic sensitivity in the early diagnosis of RA. It may also help differentiate those with psoriatic arthritis joint damage from those without joint damage.

Excessive formation of ketone bodies (acetone) results in increased blood levels (ketonemia) and increased excretion in the urine (ketonuria). This condition is associated with a decreased availability of carbohydrates, such as dieting or decreased use of carbohydrates. Diabetes and alcohol consumption are common causes of ketoacidosis. Acetone is one ketone body formed from acetoacetate. Ingestion of isopropyl alcohol also leads to the formation of acetone.

The adiponectin ELISA assay quantitatively measures human adiponectin in serum. It has been shown that decreased expression of adiponectin correlates with insulin resistance. Adiponectin appears to be a potent insulin enhancer linking adipose tissue and whole body glucose metabolism.

Description: The Alpha-1-Antitrypsin Quantitative test measures levels of the alpha-1-antitrypsin protein in the blood.

Also Known As: Alpha1-antitrypsin Test, A1AT Test, AAT Test, Alpha 1 Antitrypsin Serum Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alpha-1-Antitrypsin test ordered?

When Alpha-1 antitrypsin tests may be prescribed:

• Jaundice that lasts more than a week or two in a baby, an enlarged spleen, fluid buildup in the belly, persistent itching, and other symptoms of liver damage are present.
• A person with COPD, elevated, sensitive skin lesions that develop into ulcers, granulomatosis with polyangiitis, or unexplained airway widening may be of any age.
• Wheezing, a persistent cough, bronchitis, shortness of breath after exercise, and/or other emphysema symptoms often appear in people under the age of 40. This is particularly true when the person is not a smoker, has not been exposed to known lung irritants, and when the lung damage appears to be low in the lungs.
• Someone has an alpha-1 antitrypsin deficiency that runs in their family.
• A person wants to know how likely it is that their child would experience the same problems as their impacted family member.

The American Thoracic Society advised AAT testing in their 2003 guidelines when people were diagnosed with diseases like:

• Young age for onset of emphysema and/or absence of clear risk factors for the condition, such as smoking
• Bronchiectasis
• difficult-to-treat asthma Unknown origin of liver disease
• Panniculitis with necrosis

The Alpha-1 Foundation suggests AAT testing for all people with:

• COPD
• illness of the liver with no known cause
• Panniculitis with necrosis
• Polyangiitis and granulomatosis
• mysterious bronchiectasis

The Alpha-1 Foundation also advises providing genetic counseling and AAT testing to people who have immediate or extended family members who have an aberrant AAT gene.

What does an Alpha-1-Antitrypsin blood test check for?

A blood protein called alpha-1 antitrypsin shields the lungs from harm from enzymes that have been activated. To help with the diagnosis of alpha-1 antitrypsin deficiency, laboratory tests detect the amount of AAT in blood or find aberrant forms of AAT that a person has inherited.

The most significant enzyme that AAT aids in inactivating is elastase. Elastase is a white blood cell termed a neutrophil that is created as part of the body's normal response to inflammation and injury. Elastase disassembles proteins so that the body can eliminate and recycle them. Elastase will also start to degrade and harm lung tissue if its activity is not controlled by AAT.

The gene that codes for AAT is inherited twice every person. The protease inhibitor gene is what it is known as. Because of the co-dominance of this gene, the body produces half of its AAT from each copy of the SERPINA1 gene. Less AAT and/or AAT with diminished function are produced if there is a change or mutation in one or both of the gene copies.

Alpha-1 antitrypsin deficiency is a condition that affects a person whose AAT production falls below 30% of normal. Emphysema, a progressive lung illness, is a serious danger for people with this disorder to experience in their early adult years. The lung damage likely to happen sooner and be more severe if they smoke or are exposed to occupational dust or fumes.

AAT that is dysfunctional of a particular sort builds up in the cells of the liver, where it is created. As AAT accumulates in these cells, it starts to produce aberrant protein chains, which then start to kill the cells and harm the liver. AAT-deficient neonates are jaundiced and suffer liver damage in about 10% of cases. These infants may need a liver transplant to survive in serious circumstances. The most frequent genetic cause of liver disease in children is presently AAT deficiency.

Adults with an AAT deficiency are more likely to develop liver cancer, cirrhosis, and chronic liver disease. Adults with AAT insufficiency rarely experience symptoms or indicators of liver damage, nevertheless. The hereditary gene mutation determines the amount and function of the AAT. The SERPINA1 gene contains more than 120 distinct alleles, however only a few of them are widespread. 90% of Americans have two copies of the typical, "wild type," M gene. S and Z are the aberrant genes that are most frequently found.

Lab tests often ordered with an Alpha-1-Antitrypsin test:

• Protein Electrophoresis
• Total Protein
• Hepatic Function Panel
• Blood Gases

Conditions where an Alpha-1-Antitrypsin test is recommended:

• Lung Disease
• Liver Disease
• Asthma

How does my health care provider use an Alpha-1-Antitrypsin test?

When a patient has early onset emphysema or chronic obstructive pulmonary disease but no clear risk factors, such as smoking or exposure to lung irritants like dust or fumes, alpha-1 antitrypsin testing is utilized to help diagnose alpha-1 antitrypsin deficiency as the cause. It may also be applied to asthmatics who continue to have breathing difficulties despite receiving treatment.

Other symptoms of unexplained liver injury, such as prolonged jaundice, are also diagnosed with the use of testing. This can be done on anyone of any age, but is typically done on infants and young children.

A person with a family history of alpha-1 antitrypsin deficiency may also undergo testing to identify whether they have one or two copies of the SERPINA1 gene.

There are typically three different AAT exam kinds. One or more of these could be applied to assess a person:

• The protein alpha-1 antitrypsin in blood is measured by alpha-1 antitrypsin.
• Testing for the phenotype of alpha-1 antitrypsin assesses the quantity and kind of AAT being produced and contrasts it with typical patterns.
• To determine if the typical wild type M allele or variant alleles are present in the SERPINA1 gene, alpha-1 antitrypsin genotyping testing can be utilized. This test won't find every variant, but it will find the most prevalent ones as well as those that might be frequent in a specific region or family. Other family members may be examined to determine their own risk of acquiring emphysema and/or liver dysfunction as well as the possibility that their children may inherit the condition after the sick person's SERPINA1 gene alleles have been determined.

Although gene sequencing for AAT is uncommon, it might be required to find uncommon alleles and make a precise diagnosis.

What do my Alpha-1-Antitrypsin test results mean?

Alpha-1 antitrypsin deficiency may be present in a person whose blood has a low amount of AAT, according to the test results. The risk of developing emphysema and other conditions linked to AAT insufficiency increases with decreasing AAT levels.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: A C-peptide test is a test that will measure the amount of C-peptide, a short amino acid chain, in the blood. This test can be used to determine if the beta cells in the pancreas are producing enough insulin. It can also be used to evaluate the reason for low blood glucose.

Also Known As: Insulin C-Peptide Test, Connecting Peptide Insulin Test, Proinsulin C-peptide test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting is required.

When is a C-Peptide test ordered?

When a person is initially diagnosed with type 1 diabetes, C-peptide levels may be ordered as part of a "residual beta cell function" study.

When a person has type 2 diabetes, a health practitioner may request the test on a regular basis to track the state of their beta cells and insulin production over time and assess whether or not insulin injections are needed.

When there is reported acute or recurring low blood glucose and/or excess insulin is suspected, C-peptide levels can be measured.

A C-peptide test may be conducted on a regular basis after a person has been diagnosed with an insulinoma to assess treatment effectiveness and detect tumor recurrence.

When a person's pancreas has been removed or has had pancreas islet cell transplants, C-peptide levels may be tracked over time.

What does a C-Peptide blood test check for?

C-peptide is a chemical made up of a short chain of amino acids that is released into the bloodstream as a byproduct of the pancreas producing insulin. This test determines how much C-peptide is present in a blood or urine sample.

Proinsulin, a physiologically inactive molecule, splits apart in the pancreas, within specialized cells called beta cells, to generate one molecule of C-peptide and one molecule of insulin. Insulin is necessary on a regular basis for the transport of glucose into the body's cells. When insulin is needed and released into the bloodstream in reaction to elevated glucose levels, equal amounts of C-peptide are also released. C-peptide can be used as a measure of insulin production because it is produced at the same rate as insulin.

C-peptide testing, in instance, can be used to assess the body's insulin production and distinguish it from insulin that is not produced by the body but is given as diabetes medication and hence does not generate C-peptide. This test can be done in conjunction with a blood test for insulin.

Lab tests often ordered with a C-Peptide test:

• Insulin
• Glucose

Conditions where a C-Peptide test is recommended:

• Diabetes
• Kidney Disease
• Liver Disease
• Insulin Resistance
• Metabolic Syndrome

How does my health care provider use a C-Peptide test?

C-peptide testing can be used for a variety of reasons. When proinsulin breaks into one molecule of C-peptide and one molecule of insulin, C-peptide is created by the beta cells in the pancreas. Insulin is a hormone that allows the body to use glucose as its primary energy source. C-peptide is a helpful measure of insulin production since it is produced at the same rate as insulin.

A C-peptide test is not used to diagnose diabetes; however, when a person is newly diagnosed with diabetes, it may be ordered alone or in conjunction with an insulin level to evaluate how much insulin the pancreas is currently making.

The body becomes resistant to the effects of insulin in type 2 diabetes, so it compensates by manufacturing and releasing more insulin, which can destroy beta cells. Oral medications are commonly used to help type 2 diabetics stimulate their bodies to produce more insulin and/or make their cells more receptive to the insulin that is already produced. Type 2 diabetics may eventually produce very little insulin as a result of beta cell loss, necessitating insulin injections. Because any insulin produced by the body is reflected in the C-peptide level, the C-peptide test can be used to track beta cell activity and capability over time and to assist a health care provider in deciding when to start insulin treatment.

Antibodies to insulin can develop in people on insulin therapy, independent of the source of the insulin. These often interfere with insulin assays, making it difficult to assess endogenous insulin production directly. C-peptide measurement is a good alternative to insulin testing in certain situations.

C-peptide levels can also be utilized in conjunction with insulin and glucose levels to help determine the source of hypoglycemia and track its therapy. Excessive insulin supplementation, alcohol intake, hereditary liver enzyme deficits, liver or kidney illness, or insulinomas can all cause hypoglycemia symptoms.

Insulinomas can be diagnosed with the C-peptide test. These are tumors of the pancreas' islet cells, which can produce excessive levels of insulin and C-peptide, resulting in abrupt hypoglycemia. C-peptide testing can be used to track how well insulinoma treatment is working and to detect recurrence.

A C-peptide test may be performed to help evaluate a person who has been diagnosed with metabolic syndrome, a group of risk factors that includes abdominal obesity, high blood pressure, and elevated blood glucose and/or insulin resistance.

C-peptide levels are occasionally used to verify the effectiveness of treatment and the procedure's sustained success after someone has had his pancreatic removed or has had pancreas islet cell transplants to restore the ability to manufacture insulin.

What do my C-Peptide test results mean?

A high level of C-peptide implies that endogenous insulin synthesis is high. This could be a result of a high blood glucose level brought on by carbohydrate consumption and/or insulin resistance. Insulinomas, low blood potassium, Cushing syndrome, and renal failure are all linked to a high level of C-peptide.

C-peptide levels that are decreasing in someone with an insulinoma suggest a response to treatment when used for monitoring; levels that are increasing may indicate a tumor recurrence when used for monitoring.

A low amount of C-peptide is linked to a reduction in insulin synthesis. This can happen when the beta cells generate insufficient insulin, as in diabetes, or when their production is reduced by exogenous insulin administration.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

C-Peptide is useful in distinguishing insulin-secreting tumors, i.e., insulinomas, from exogenous insulin administration. C-Peptide concentrations are severely depressed or absent in Type 1 diabetes mellitus. C-Peptide is also useful in monitoring patients who have received islet cell or pancreatic transplants. It is also measured as an additional means for evaluating glucose tolerance and glibenclamide-glucose tests.

C-Peptide is useful in distinguishing insulin-secreting tumors, i.e., insulinomas, from exogenous insulin administration. C-Peptide concentrations are severely depressed or absent in Type 1 diabetes mellitus. C-Peptide is also useful in monitoring patients who have received islet cell or pancreatic transplants. It is also measured as an additional means for evaluating glucose tolerance and glibenclamide-glucose tests.

C-Peptide is useful in distinguishing insulin-secreting tumors, i.e., insulinomas, from exogenous insulin administration. C-Peptide concentrations are severely depressed or absent in Type 1 diabetes mellitus. C-Peptide is also useful in monitoring patients who have received islet cell or pancreatic transplants. It is also measured as an additional means for evaluating glucose tolerance and glibenclamide-glucose tests.

C-Peptide is useful in distinguishing insulin-secreting tumors, i.e., insulinomas, from exogenous insulin administration. C-Peptide concentrations are severely depressed or absent in Type 1 diabetes mellitus. C-Peptide is also useful in monitoring patients who have received islet cell or pancreatic transplants. It is also measured as an additional means for evaluating glucose tolerance and glibenclamide-glucose tests.