Diabetes is a chronic metabolic disease that is often associated with structural and functional changes in multiple tissues and organs. Timely tests are extremely important in guiding treatment and preventing complications.
So, what tests do diabetic patients need to do?
I. Blood and urine laboratory tests.
1.Glucose monitoring: Patients with diabetes should decide the frequency and time of blood glucose check according to the specific situation. In the early stage of the disease, or when adjusting the treatment plan, or changing the diet and exercise routine, it is recommended to increase the number of monitoring appropriately.
2.Urine ketone body measurement: If the result shows + or ++++, it means that the urine contains 5~160mg/dl ketone body.
3.C-peptide measurement: insulin is cleaved into one molecule of insulinogen and the same one molecule of linking peptide under the action of enzymes, referred to as C-peptide. C-peptide has no physiological effect of insulin, while islet B cells secrete insulin and C-peptide in an equimolecular relationship. In other words, the secretion of several insulin molecules must be accompanied by the secretion of several C-peptide molecules. Therefore, by measuring the amount of C-peptide in the patient’s blood, the function of islet cells can be reflected.
Clinical values.
1, C-peptide is not interfered by insulin antibody, and patients receiving insulin therapy can also measure C-peptide directly to judge the condition.
2.It can identify various causes of hypoglycemia. If C-peptide exceeds normal, it can be considered as the result of excessive insulin secretion.
3.The regular measurement of C-peptide concentration is important to understand the function of pancreatic islets, the severity of the disease and the clinical treatment effect of patients.
4.Glycated hemoglobin measurement: reflecting the blood glucose situation 8 to 12 weeks before blood sampling, it is recommended to test once every 2 to 3 months.
5.Lipid examination (mainly including total cholesterol, triglycerides, LDL cholesterol, etc.): diabetic patients are often accompanied by dyslipidemia, which can easily cause atherosclerosis and various cardiovascular diseases.
6, liver and kidney function: diabetic nephropathy is a common chronic complication of diabetes. Urine microalbumin quantification, kidney function and other tests can help detect diabetic nephropathy at an early stage. Many type 2 diabetic patients often have obesity, dyslipidemia, fatty liver and abnormal liver function at the same time, so liver function and lipid tests should also be done.
7, urine examination: observation of the presence of urine protein, tubular type, etc., can reflect the kidney involvement; increased white blood cells in the urine indicates that the patient has urinary tract infection; increased red blood cells in the urine may be due to complications such as glomerulosclerosis, small renal artery sclerosis, pyelonephritis. Microalbumin and 24-hour urine protein quantification in urine can help in the early diagnosis of diabetic nephropathy.
II. Other special examinations.
1, heart and lower limb vascular examination: for diabetic patients, the absence of heart disease symptoms does not mean that there is no problem with the heart, it is necessary to do ECG and cardiac ultrasound examination in time. Routine electrocardiogram can detect various arrhythmias and understand the blood supply to the heart muscle. In addition, lower extremity vascular ultrasound and imaging can understand the presence of lower extremity arteriosclerosis or stenosis, so that early detection of diabetic foot.
2, blood pressure examination: the incidence of hypertension in diabetic patients is 2 to 6 times higher than the general population, and the ideal target for blood pressure control in diabetic patients is about 120/80mmHg.
3.Ophthalmology examination: diabetes can cause retinopathy, serious cases can be blind, should be regular and routine fundus examination. Ophthalmological examination can detect diabetic retinopathy and cataract, which can cause gradual loss of vision, blurred vision or sudden blindness.
4.X-ray chest examination: the incidence of tuberculosis is 3 to 4 times higher in diabetic patients than in non-diabetic patients. Chest X-ray can clarify whether tuberculosis or lung infection is combined at the same time.
5.Abdominal ultrasound: It can find out whether diabetic patients have cholecystitis, gallstones, kidney lesions, pancreatic calcification or stones, etc.
6.Bone densitometry: It helps to detect osteoporosis.
7.Neurological examination: Tactile examination with 10 grams of single nylon wire can detect diabetic peripheral neuropathy at an early stage.
8.CT examination: Once the patient has hand and foot incompetence, altered consciousness, crooked mouth, choking and coughing, etc., a cranial CT examination should be done in order to clarify the presence of cerebral hemorrhage or cerebral infarction.