C-Peptide - A specific determinant for appropriate therapy
The measurement of C-peptide levels can be a useful aid in the diagnosis and treatment of abnormal insulin secretions.
C-peptide levels measured in response to intravenous glucagon can provide useful information when attempting to differentiate between type 1 and type 2 diabetes in difficult cases.
Measurement of C-peptide is valuable in the investigation of possible factitious hypoglycemia attributable to surreptitious insulin administration.
Used in the diagnosis and treatment of certain renal diseases, in monitoring renal dialysis, and as a calculation basis for measuring other urine analytes.
Creatinine is used routinely as part of a comprehensive or basic metabolic panel, if your doctor suspects that you have from kidney dysfunction, and at intervals to monitor treatment for kidney disease or kidney function while on certain medications.
Cystatin C - Sensitivity and specificity when assessing renal function
There are currently more than 200 million diabetics worldwide,1 with diabetes being the most common cause of kidney failure. Cystatin C is used as an alternative to creatinine and creatinine clearance to screen for and monitor kidney dysfunction. Studies demonstrate that serial measurements of serum Cystatin C provide an accurate estimation of trends in kidney function in patients with diabetes and normal or elevated glomerular filtration rate (GFR).2
Patients who may benefit most from GFR assessment in using Cystatin C include those at high risk for chronic kidney disease where monitoring is required, including diabetics.
1. International Diabetes Federation (idf.org/diabetes) 2. Perkins, 2005
Glucose measurements are used in the diagnosis and treatment of disorders of carbohydrate metabolism such as diabetes, hypoglycemia and insulinoma. Diabetes is a common disease that begins with few symptoms, and therefore glucose testing is often used to screen healthy, asymptomatic individuals for pre-diabetes and diabetes. Screening is especially important for people at high risk of developing diabetes, such as those with a family history of diabetes, those who are overweight, and those who are more than 40 to 45 years old. Glucose testing is also commonly used to diagnose diabetes that occurs during pregnancy (gestational diabetes).
A glucose test may also be ordered to help diagnose diabetes when someone has symptoms of hyperglycemia (high blood sugar level) or hypoglycemia (low blood sugar level). A glucose test in combination with a C-peptide test can determine the cause of hypoglycemia.
HbA1c – A simple test to help control your diabetes
Measurements of hemoglobin A1c (HbA1c) are effective in monitoring long-term glucose control in individuals with diabetes. Studies have shown that improving HbA1c control can greatly reduce the risk of complications from diabetes, including:
- Kidney disease
- Eye damage
- Heart disease
As little as a 1% decrease in HbA1c levels can lead to a 25% reduction in the risk of such complications.1
The American Diabetes Association (ADA) recommends that anyone with diabetes have their HbA1c levels tested at least once every six months and every three months if your HbA1c level is not meeting treatment goals.
Insulin – An important tool for distinguishing Type 1 from Type 2 Diabetes
Measurement of insulin levels can be used to aid in the selection of the most appropriate antihyperglycemic agent in patients with type 2 diabetes. It is believed that the lower the pretreatment insulin concentration, the more appropriate insulin might be as the drug of choice to initiate treatment.
Fasting insulin-to-glucose levels may be valuable in the assessment of insulin resistance in diabetics as well as in women with polycystic ovary syndrome (PCOS).
Insulin measurements are also used to establish the pathogenesis of fasting hypoglycemia. The diagnosis of an islet cell tumor, for instance, is based on the persistence of inappropriately increased plasma insulin levels in the presence of low glucose levels.
Urinary Albumin – A sensitive marker for diabetic nephropathy
Determination of urinary albumin is a valuable tool for the detection of diabetic nephropathy. Early detection of microalbuminuria in diabetics is critical because immediate intervention can slow the progression of disease.
Siemens’ sensitive urinary albumin assay is a valuable tool for the detection of microalbuminuria as an aid in the detection of diabetic nephropathy. The International Diabetes Federation and American Diabetes Association recommend that annual urinary albumin testing of patients without clinical proteinuria should begin in pubertal or postpubertal individuals 5 years after diagnosis of type 1 diabetes and at the time of diagnosis of type 2 diabetes.
Additionally, studies have suggested that postmenopausal women with microalbuminuria are at increased risk for cardiac mortality, and their urinary albumin levels should also be monitored yearly.