Sugar Matters
November 20, 2012

More blood tests???

There are days when you probably feel like you had a vampire attacking you when you, had blood drawn at the lab — you see vial after vial being filled and you start to feel faint just looking at it. Why do they need all this blood anyway? Well, in addition to the Hemoglobin A1C (HbA1C) and glucose, there are some other important things your doctor will keep an eye on when you have diabetes.{{more}}

1) Kidney and electrolyte tests: Why do they need this, you ask, when a few weeks ago I talked about using urine tests for kidney damage? The blood works in addition to the urine test to give a more complete picture. The Creatinine (Cr) measure on the test is commonly used to follow kidney function, and importantly determine what medications may be safe for you. Many medications pass through the kidneys, and if you have some damage, then some medications may not be safe anymore. For example, Ibuprofen, which many people take for headaches — if your creatinine is above a certain level, you should not take this medication.

Another reason for this test is that it looks at sodium and potassium levels. Diabetes itself can cause some changes in these values, especially the potassium, but many blood pressure medications can also change these levels around. Your doctor needs to keep a very close eye on these numbers to make sure they are neither too high nor too low.

2) Liver tests — when I talk about liver tests usually patients jump up and start berating their diabetes and cholesterol medicines, saying “I knew those medicines would mess up my liver.” Believe it or not, that happens MUCH LESS often that you think. There is always news about this medicine and that medicine causing liver damage, but the truth is that this happens very infrequently with the commonly used diabetes and cholesterol medicines (when used properly). What many people do not know is that diabetes ITSELF causes high liver tests in many people, and getting the sugars controlled can reverse this in some folks. Initial liver testing is also important, because if you already have some liver damage from diabetes, then some medications are not safe for you to use until the liver returns closer to normal. And yes, in addition your liver should be watched when you are on cholesterol medicines, in case you end up being one of the people who reacts to the medication.

3) Cholesterol panel — People with diabetes tend to have high cholesterol. Sometimes getting blood sugars down to normal will bring the cholesterol to normal, but more often you also need some cholesterol medication to help out. Yes, you should watch your diet anyway – don’t decide to eat all manner of badness because you are taking a cholesterol pill. The souse is still not a good idea! High cholesterol is not good for anybody, but in diabetics it is especially dangerous and multiplies your chances of having heart problems and strokes, so pay close attention to those numbers.

There are a few other interesting blood tests that your doctor may check when you have diabetes, but that is often situation specific. So next time in the lab, close your eyes and think about that blood going to good use. Until next week, stay safe and healthy Vincies.

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227