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Blood Sugar -
(Fasting, Random or 2hr. Post Prandial) |
$20.00 |
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How is
it used?
The blood sugar (glucose)
test is ordered to measure the amount of glucose
in your blood right at the time of sample
collection. It is used to detect both
hyperglycemia and hypoglycemia, to help diagnose
diabetes,
and to monitor glucose levels in persons with
diabetes. Blood glucose may be measured on a
fasting basis (collected after an 8 to 10 hour
fast), randomly (anytime), post prandial (after
a meal), and/or as part of an oral glucose
tolerance test (OGTT / GTT).
An OGTT is a series of blood glucose tests. A
fasting glucose is collected; then the patient
drinks a standard amount of a glucose solution
to "challenge" their system. This is followed by
one or more additional glucose tests performed
at specific intervals to track glucose levels
over time. The OGTT may be ordered to help
diagnose diabetes and as a follow-up test to an
elevated blood glucose.
The
American Diabetes Association recommends either
the fasting glucose or the OGTT to diagnose
diabetes but says that testing should be done
twice, at different times, in order to confirm a
diagnosis of diabetes.
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Glycated
Hemoglobin (HbA1c) |
$68.00 |
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The
A1c test is frequently used to help newly
diagnosed diabetics determine how elevated their
uncontrolled blood glucose levels have been. It
may be ordered several times while control is
being achieved, and then several times a year to
verify that good control is being maintained.
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 and many
identified
hemoglobin variants,
but the predominant form – about 95-98% – is
hemoglobin A. Hemoglobin A can be further
subdivided, with one of the subcomponents known
as hemoglobin A1c. As glucose circulates in the
blood, some of it spontaneously binds to
hemoglobin A. The glucose-hemoglobin molecules
formed are said to be glycated. 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 combination of glucose and
hemoglobin A 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.
The way that the A1c is
reported is in the process of changing.
Traditionally, in the United States, the A1c has
been reported as a percentage, and the American
Diabetes Association (ADA) has recommended that
people with diabetes
strive to keep their A1c below 7%. While this is
still true, more than a decade of national and
international efforts to improve and standardize
the A1c test and its reporting led to the
release of a consensus statement in 2007 by the
ADA, the European Association for the Study of
Diabetes, the International Federation of
Clinical Chemistry and Laboratory Medicine (IFCC),
and the International Diabetes Federation.
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Blood Sugar - Fasting & 2Hr. Post-Prandial |
$40.00 |
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Blood Sugar (Glucose) is the
primary energy source for all
body tissues. The sugars and
carbohydrates you eat are
ordinarily converted into
glucose, which can be either
used to produce immediate energy
or stored as "Glycogen" in the
liver or as fat throughout the
body. Glycogen and fat thus
serve as sources of reserve
energy. The body can also
manufacture glucose from fats
and amino acids. Glucose can be
measured in either the blood or
the urine.
When you wish to have your blood
tested, we recommend that you
have fasted for 12-14 hours
(fasting blood sugar, or FBS).
Another useful measurement of
your blood sugar is two hours
after your main meal. (2-hour
postprandial blood sugar, or
2-hour pp).
When neither a fast nor a
special meal is observed prior
to the test, it is called a
random blood sugar (RBS).
Urine normally contains very
little or no sugar. A positive
urine test for sugar requires
that you check your blood
glucose. However, when the blood
sugar level is very high, as in
diabetes, the ability of the
kidney to keep sugar out of the
urine may be exceeded. The level
of blood glucose at which
glucose spills into the urine is
called the "renal threshold",
and is usually between 160 and
180 milligrams per deciliter.
Sugar that spills into the urine
carries a large volume of water
with it, producing the two
classic symptoms of diabetes:
excessive urination and thirst.
MILD ELEVATION of your blood
sugar (120 to 150 mg/dl) may be
caused by diabetes, pregnancy,
hypertension, hyperthyroidism,
excessive pituitary function,
excessive adrenal function,
obesity, thiazide diuretics, or
a recent heavy meal.
MODERATE ELEVATION of your blood
sugar (150 to 500 mg/dl) may be
caused by diabetes, recent
anesthesia, carbon monoxide
poisoning, infectious disease,
or disease of the central
nervous system.
HIGH LEVELS of blood sugar are
always associated with diabetes.
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Microalbuminuria
(Protein Loss
Screen) |
$58.00 |
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Diabetes and Hypertension are the two most
common cause of loss of Proteins through the
kidney, a condition called Proteinuria.
Proteinuria is an abnormally high amount of
protein in the urine. Proteins in the blood,
like albumin and immunoglobulin, help
coagulation (clotting), balance bodily fluids,
and fight infection. The kidneys remove wastes
from protein-rich blood through millions of tiny
filtering screens called glomeruli.
Most proteins are too large to pass through into
the urine. The glomeruli are negatively charged,
so they repel the negatively charged proteins.
Thus, a size and charge barrier keeps protein
molecules from entering the urine. But when the
glomeruli are damaged, proteins of various sizes
pass through them and are excreted in the urine.
Signs and Symptoms
Foamy urine and swelling (edema) are two signs
of proteinuria that become more evident as the
disease progresses. Excess protein can cause the
urine to foam in water. This occurs because
protein changes the surface tension between
urine and water. Edema usually only occurs in
nephrotic range proteinuria.
Albumin is particularly useful in absorbing
bodily fluid into the blood. Because the albumin
molecule is relatively small, it is often among
the first proteins to enter the urine after
glomeruli are damaged. Therefore, even minor
kidney dysfunction is detectable with proper
diagnosis of micralbuminuria. Reduced albumin
level in the blood causes fluid retention and
swelling that is first noticeable in the hands,
lower legs, and feet. In more serious cases, the
abdomen and face may swell.
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Types
The
following five types of proteinuria are
distinguished by milligrams (mg) of protein
measured during a 24-hour urine collection:
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1. Microalbuminuria |
30 - 150 mg |
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2. Mild |
150 – 500 mg |
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3. Moderate |
500 – 1000 mg |
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4. Heavy |
1000 – 3000 mg |
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5. Nephrotic range |
more than 3500 mg |
As
kidney disease progresses, more protein enters
the urine, condition called Nephrotic Syndrome.
Complications
Hypertensive people who develop proteinuria
stand a significant chance for kidney failure.
African Americans are 20 times more likely than
Caucasians to develop hypertensive-related
kidney failure. Proteinuria in people with
diabetes may be a sign that kidney disease is
worsening. Microalbuminuria is often cited as a
risk for coronary artery disease (CAD) and is
often diagnostic of it and related
cardiovascular conditions.
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BUN (Blood Urea Nitrogen) |
$35.00 |
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BUN is used to evaluate kidney function or
monitor the effectiveness of dialysis and other
treatments related to kidney disease or damage
This test measures the amount of urea nitrogen
in the blood. Nitrogen, in the form of ammonia,
is produced in the liver when protein is broken
into its component parts (amino acids) and
metabolized.
The nitrogen combines with other molecules in
the liver to form the waste product urea. The
urea is then released into the bloodstream and
carried to the kidneys, where it is filtered out
of the blood and excreted in the urine. Since
this is an ongoing process, there is usually a
small but stable amount of urea nitrogen in the
blood.
Most diseases or conditions that affect the
kidneys or liver have the potential to affect
the amount of urea present in the blood. If
increased amounts of urea are produced by the
liver or decreased amounts are excreted by the
kidneys, then urea concentrations will rise. If
significant liver damage or disease inhibits the
production of urea, then BUN concentrations may
fall.
The BUN test is primarily
used, along with the creatinine test, to
evaluate kidney function in a wide range of
circumstances, to help diagnose
kidney disease,
and to monitor patients with acute or chronic
kidney dysfunction or failure. It also may be
used to evaluate a person’s general health
status when ordered as part of a
basic metabolic panel
(BMP) or
comprehensive metabolic panel (CMP).
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Lipid Profile |
$68.00 |
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This
profile requires you to be fasting 12-14 hours. No appointment necessary.
Components of a Lipid Profile
Total Cholesterol
Cholesterol is a necessary
substance in your body from your first day of life. Experts recommend a
cholesterol level below 200 for good health. Between 200 and 239 is
borderline and above 240 is dangerous. When associated with at least two risk
factors such as high blood pressure, diabetes, previous heart disease or stroke,
excess weight and being a smoker, t increases the incidence of having coronary
artery disease and heart attacks.
HDL (Good
Cholesterol)
High density lipoproteins
(HDL) are proteins coated "packages" that carry fat and cholesterol through the
body. The function of HDL is to remove cholesterol from the blood by
transporting it to the liver where it will be prepared for excretion through the
bile. HDL has a protective effect on the deposit of fat in the wall of blood
vessels. Increasing its level in the blood will reduce the risk of
cardiovascular disease. The use of polyunsaturated, monounsaturated fats (Olive
Oil), and physical exercise may increase the level of HDL.
Triglycerides
Triglycerides are a type
of fatty substance which must be measured together with your cholesterol for a
complete picture of your circulating blood fats. Blood triglycerides tend
to be elevated in people who have high cholesterol levels, in people with
diabetes or chronic kidney disease, and in those who are obese. The
relationship between triglycerides and coronary artery disease is still
controversial. Some studies suggest that high blood triglycerides might increase
the risk of coronary artery disease. If your blood level of triglycerides is
elevated you should consult your doctor for dietary changes and weight loss and
exercise program or for the use of medication which may be necessary in
some cases.
LDL
(Bad Cholesterol)
Low density lipoproteins (LDL)
transport one half to two thirds of all blood cholesterol to various body
tissues. A certain amount of LDL cholesterol (up to 130) is normal. But when the
level increases, LDL promotes plaque development on the walls of the coronary
arteries, slowing the flow of blood and sometimes blocking the artery entirely.
Levels of 130-160 are considered borderline high and levels of 160 or higher are
definitely abnormal and should be reduced with rigorous diet, other lifestyle
changes, and/or with drug therapy.
Controversies are now surfacing on the danger of having LDL blood
levels which are too low. The relation to some type of cancers and other
diseases have been noticed with LDL levels reduced below 90 and closer to 50.
Therefore is unclear today how safe is to lower your LDL blood level. A safer
level seems to be between 90-130 and should be associated with an increase in
the HDL levels.
VLDL
(Very Low Density Lipoprotein)
VLDL (Very Low
Density Lipoprotein) is a fraction of Triglycerides circulating in your blood
stream. Not as important as the LDL, this blood fats follows the levels of your
Triglycerides.
Tryglycerides levels may be elevated either for the presence of high fats in
your food which when absorbed in your intestine is transformed as Chylomicrons
and give a milky appearance to the liquid part of your blood ( serum ) or for
the presence of Very Low Density Lipoproteins (VLDL) which is the part of
Triglycerides produced by your body and not ingested with food.
Cholesterol/HDL Ratio
The HDL in the blood is
believed to serve two functions: 1) it coats the inside
of the artery wall and provide a kind of protective layer of grease
to prevent fat deposits from building up and 2) it serves as scavenger by
actually helping dissolve fatty deposits when they occur. The basic rule of
balance for your blood is to have a relatively high amount of HDL in your body
in relation to your total amount of cholesterol. This is called the Cholesterol/HDL
Ratio.
The ratio in men should always be less than 5.0, and preferably less than
4.5. For women, the ratio should be lower and always under 4.0 and preferably
under 3.5. In other words the man's HDL should always represent at least 20% of
the total cholesterol count (and preferably should be 25% or
greater). For a woman the HDL cholesterol should make up at least
25% (or preferably 30%) of the total cholesterol. The Cholesterol/HDL
Ratio is probably the best predictor of future coronary disease. Active people
with low levels of body fat tend to show the best cholesterol balance (ratio) in
their blood.
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