Monitoring of diabetes mellitus
المؤلف:
Marcello Ciaccio
المصدر:
Clinical and Laboratory Medicine Textbook 2021
الجزء والصفحة:
p395-396
2025-10-19
80
The clinical laboratory also plays a fundamental role in monitoring patients with diabetes mellitus to evaluate the correct glycemic compensation and/or the possible onset of alterations allowing to promptly modify treatment.
The following laboratory tests must be performed at least once a year:
– Urinalysis to assess glycosuria (glycemia >180 mg/dL); ketonuria (frequent in decompensated DM1); and albuminuria (>30 mg/24 h or > 30 mg/g creatinine), which represents an important biomarker of diabetic nephropathy and is associated with a significant risk of cardiovascular disease
– Estimated GFR (eGFR) to assess renal function
– Ketonemia
– Complete lipid profile
– HbA1c to assess long-term glycometabolic control
– Glycated albumin to assess midterm glycometabolic control
– C-peptide to assess the residual secretory capacity of pancreatic β-cells
– Insulin, especially in patients with DM2, to assess the degree of insulin resistance. Insulin should be measured after stimulation (OGTT). In patients with DM2, the insulinemic response will be delayed and persistent.
Measurement of glycated hemoglobin is the gold standard for glycometabolic controlevaluation in diabetic patients (Table 2).
Table2. Interpretation of glycated hemoglobin (HbA1c) values
The guidelines recommend to measure HbA1C:
– Two times per year in patients with stable metabolic control and who have reached the therapeutic target
– More than two times per year in patients with unstable metabolic control
It is inappropriate to measure HbA1C less than 2 months apart.
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