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Health Checkup

Advanced Diabetic Package

Diabetes
68 parametersReport in 24HrsAt Home

Fasting Required

Details

Advanced diabetic package covering insulin, sugar, glucose, iron, liver, kidney, lipid, thyroid, pancreas, blood and electrolytes

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Parameters

  • List of Tests
    • Microalbumin
    • C-Peptide Fasting
    • Iron Studies
      • Iron
      • TIBC
      • Transferrin Saturation
    • Liver Function Test
      • Albumin
      • Alkaline Phosphatase
      • Bilirubin - Direct
      • Bilirubin - Indirect
      • Bilirubin - Total
      • AST/SGOT
      • ALT/SGPT
      • Total Protein
      • A/G Ratio
      • Gamma GT
      • Globulin
    • Kidney Profile
      • BUN
      • Calcium
      • Creatinine
      • Uric Acid
      • eGFR
      • BUN/Creatinine
      • Urea
    • Lipid Profile
      • Cholestrol/HDL
      • LDL/HDL
      • Non HDL
      • VLDL
      • Total Cholestrol
      • Triglycerides
      • HDL
      • LDL
    • Thyroid Profile
      • Total T3
      • Total T4
      • TSH
    • Hba1c
    • eAG
    • Insulin Fasting
    • Pancreatic Profile
      • Amylase
      • Lipase
    • CBC - Complete Hemogram
    • Serum Electrolytes
      • Na
      • K
      • Cl

Advanced Diabetic Package

  • Why is it done?
    • Comprehensive diabetes screening and monitoring to evaluate glycemic control, pancreatic function, and metabolic status in both newly diagnosed and established diabetic patients
    • HbA1c and eAG assess long-term glycemic control over 2-3 months, helping determine if blood sugar targets are being met
    • Fasting insulin and C-peptide measure pancreatic beta cell function and insulin secretion capacity to determine insulin resistance and diabetes type
    • Kidney profile and microalbumin detect diabetic nephropathy, one of the major microvascular complications of diabetes
    • Liver function tests monitor hepatic metabolism and detect diabetes-related fatty liver disease (NAFLD)
    • Lipid profile assesses cardiovascular risk factors; dyslipidemia is common in diabetics and increases heart disease risk
    • Thyroid profile screens for thyroid disorders, which commonly coexist with diabetes and affect glycemic control
    • Pancreatic profile (amylase and lipase) evaluates pancreatic health and screens for acute or chronic pancreatitis
    • Complete blood count identifies anemia, infection, or hematologic abnormalities common in diabetic patients
    • Iron studies assess iron metabolism and detect hemochromatosis, which can cause secondary diabetes
    • Serum electrolytes monitor sodium, potassium, and chloride levels, which are critical in diabetic patients, especially those with kidney disease or taking certain medications
    • Recommended for initial diabetes diagnosis confirmation, routine diabetes management, pre-treatment evaluation, and annual comprehensive health assessment in diabetic patients
  • Normal Range
    • Microalbumin (Urine): <30 mg/24 hours (normal); 30-300 mg/24 hours (microalbuminuria); >300 mg/24 hours (macroalbuminuria)
    • C-Peptide Fasting: 0.8-3.1 ng/mL (0.26-1.03 nmol/L); indicates residual beta cell function; levels low in Type 1 diabetes, normal or high in Type 2 diabetes
    • Insulin Fasting: 2-12 mIU/mL (14-84 pmol/L) in fasting state; elevated levels suggest insulin resistance
    • Iron: 60-170 mcg/dL (10.74-30.43 mmol/L); Total Iron Binding Capacity (TIBC): 250-425 mcg/dL (44.75-75.98 mmol/L); Transferrin Saturation: 20-50%
    • Albumin: 3.5-5.5 g/dL (35-55 g/L); indicates hepatic protein synthesis and nutritional status
    • Alkaline Phosphatase (ALP): 30-120 IU/L (varies with age and gender); higher in bone disease and cholestasis
    • Bilirubin Total: 0.3-1.2 mg/dL (5.1-20.5 mmol/L); Direct: <0.3 mg/dL (<5.1 mmol/L); Indirect: 0.1-1.2 mg/dL (1.7-20.5 mmol/L)
    • AST/SGOT: 10-40 IU/L; ALT/SGPT: 7-56 IU/L; elevated levels indicate liver cell damage
    • Total Protein: 6.0-8.3 g/dL (60-83 g/L); Globulin: 2.0-3.5 g/dL (20-35 g/L); A/G Ratio: 1.0-2.5
    • Gamma GT (GGT): 0-65 IU/L (varies with age); elevated in liver disease and cholestasis
    • BUN (Blood Urea Nitrogen): 7-20 mg/dL (2.5-7.1 mmol/L); reflects kidney function and protein metabolism
    • Creatinine: 0.7-1.3 mg/dL (62-115 mmol/L); key indicator of glomerular filtration rate and kidney function
    • eGFR (Estimated Glomerular Filtration Rate): >60 mL/min/1.73m² (normal kidney function); <60 indicates chronic kidney disease
    • BUN/Creatinine Ratio: 10-20 (normal); >20 suggests dehydration or prerenal azotemia; <10 suggests overhydration or liver disease
    • Urea: 2.5-7.1 mmol/L (7-20 mg/dL); reflects nitrogen waste from protein metabolism
    • Calcium: 8.5-10.2 mg/dL (2.12-2.55 mmol/L); important for bone health and metabolic function
    • Uric Acid: 3.5-7.2 mg/dL (0.21-0.43 mmol/L) in males; 2.6-6.0 mg/dL (0.15-0.36 mmol/L) in females; elevated in gout and kidney disease
    • Total Cholesterol: <200 mg/dL (<5.18 mmol/L) - desirable; 200-239 mg/dL - borderline; ≥240 mg/dL - high risk
    • LDL Cholesterol: <100 mg/dL (<2.59 mmol/L) - optimal; 100-129 mg/dL - near optimal; ≥160 mg/dL - high; >190 mg/dL - very high
    • HDL Cholesterol: >40 mg/dL (>1.04 mmol/L) in males; >50 mg/dL (>1.30 mmol/L) in females - protective; <40 or <50 - low/risk factor
    • Triglycerides: <150 mg/dL (<1.7 mmol/L) - normal; 150-199 mg/dL - borderline; 200-499 mg/dL - high; ≥500 mg/dL - very high
    • VLDL: 5-40 mg/dL (0.13-1.04 mmol/L) calculated as triglycerides/5
    • Total Cholesterol/HDL Ratio: <5.0 (optimal); cholesterol/HDL and LDL/HDL ratios used to assess cardiovascular risk
    • Non-HDL Cholesterol: Total Cholesterol - HDL; <130 mg/dL is optimal for cardiovascular health
    • Total T3: 80-200 ng/dL (1.2-3.1 nmol/L); Total T4: 4.5-12 mcg/dL (58-154 nmol/L); TSH: 0.4-4.0 mIU/L
    • HbA1c: <5.7% (normal); 5.7-6.4% (prediabetes); ≥6.5% (diabetes); <7% (good diabetes control target); <8% (acceptable)
    • eAG (Estimated Average Glucose): Calculated from HbA1c; <130 mg/dL suggested target for most diabetic patients
    • Amylase: 30-110 IU/L; elevated in pancreatitis or salivary gland disease
    • Lipase: 0-60 IU/L; more specific for pancreatic inflammation than amylase; elevated in pancreatitis
    • Hemoglobin: 13.5-17.5 g/dL in males; 12.0-15.5 g/dL in females; <12.0 in females indicates anemia
    • Hematocrit: 41-53% in males; 36-46% in females; reflects percentage of red blood cells in total blood volume
    • RBC Count: 4.5-5.9 million/mcL in males; 4.1-5.1 million/mcL in females; indicates oxygen-carrying capacity
    • WBC Count: 4.5-11.0 thousand/mcL; elevated in infection or inflammation; decreased in bone marrow disorders
    • Platelets: 150-400 thousand/mcL; important for blood clotting
    • Sodium (Na): 136-145 mEq/L (136-145 mmol/L); critical for fluid balance and nerve function
    • Potassium (K): 3.5-5.0 mEq/L (3.5-5.0 mmol/L); essential for cardiac and skeletal muscle function
    • Chloride (Cl): 98-107 mEq/L (98-107 mmol/L); maintains acid-base balance and osmotic pressure
  • Interpretation
    • Microalbumin: <30 mg/24h indicates normal kidney function; 30-300 mg/24h suggests early diabetic nephropathy requiring intervention; >300 mg/24h indicates advanced kidney disease; useful for detecting kidney disease before serum creatinine becomes elevated
    • C-Peptide Fasting: Low levels (<0.8 ng/mL) indicate little/no insulin production, suggesting Type 1 diabetes or advanced Type 2 diabetes; elevated levels (>3.1 ng/mL) suggest strong insulin production indicating intact beta cell function; ratios compared with glucose help calculate HOMA-IR for insulin resistance assessment
    • Insulin Fasting: Levels >12 mIU/mL suggest insulin resistance, metabolic syndrome, or early Type 2 diabetes; low levels with high glucose indicate inadequate insulin secretion; HOMA-IR (Homeostasis Model Assessment) calculated as (fasting insulin × fasting glucose)/405 with >2.0 indicating insulin resistance; not routinely diagnostic but useful for phenotyping
    • Iron: Elevated iron with high transferrin saturation (>50%) suggests hemochromatosis, which can cause secondary diabetes (hemochromatotic diabetes); low iron indicates iron deficiency anemia; high TIBC with low iron suggests iron deficiency; normal TIBC with high iron suggests hemochromatosis
    • Albumin: Low albumin (<3.5 g/dL) indicates malnutrition, liver disease, or nephrotic syndrome; in diabetics may reflect malnutrition, liver dysfunction, or protein losses in urine; normal albumin helps maintain colloid osmotic pressure
    • ALP Elevation: >120 IU/L may indicate cholestasis, bone disease, hepatic infiltration, or liver dysfunction; in diabetics may suggest metabolic bone disease or fatty liver disease; disproportionate elevation compared to AST/ALT suggests cholestatic pattern
    • Bilirubin Elevation: Total >1.2 mg/dL suggests hemolysis, cholestasis, or hepatic dysfunction; elevated indirect fraction indicates hemolysis or impaired uptake; elevated direct fraction indicates cholestasis or hepatocellular injury; in diabetics may reflect fatty liver disease
    • AST/ALT Elevation: >40 IU/L for AST or >56 IU/L for ALT suggests hepatocellular injury; AST >ALT pattern suggests chronic liver disease or hemolysis; ALT >AST suggests acute liver injury or fatty liver disease (NAFLD); both elevation indicates hepatitis; AST/ALT ratio used to assess fibrosis
    • Total Protein <6.0 g/dL indicates hypoproteinemia from malnutrition, liver disease, or renal losses; >8.3 g/dL suggests dehydration or myeloma; A/G ratio <1.0 indicates globulin excess (infection, autoimmune disease); >2.5 indicates albumin excess or globulin deficiency
    • GGT Elevation: >65 IU/L indicates cholestasis, hepatocellular disease, or alcohol-related liver damage; more specific for liver origin than ALP; correlates with oxidative stress and metabolic dysfunction
    • BUN Elevation: >20 mg/dL suggests kidney dysfunction, dehydration, or high protein diet; in diabetics indicates declining glomerular filtration; low BUN (<7 mg/dL) suggests malnutrition or liver disease; BUN rises disproportionately in prerenal azotemia (dehydration)
    • Creatinine Elevation: >1.3 mg/dL indicates reduced kidney function; in diabetics, even 'normal' creatinine may underestimate kidney disease in elderly or frail patients; creatinine doubles approximately when GFR is halved; rate of rise important for monitoring progression
    • eGFR <60 mL/min/1.73m² defines chronic kidney disease Stage 3 or higher; <30 indicates advanced kidney disease requiring specialist management; eGFR >60 with albuminuria still indicates kidney disease; used to adjust drug dosing and monitor progression
    • BUN/Creatinine Ratio >20 suggests dehydration, prerenal disease, or GI bleeding; <10 suggests overhydration, liver disease, or malnutrition; ratio helpful in distinguishing prerenal from intrinsic kidney disease
    • Urea (equivalent to BUN ÷ 2.8): Elevated urea reflects impaired kidney clearance; used in many countries outside USA; prognostic marker for kidney disease progression
    • Calcium <8.5 mg/dL suggests hypocalcemia from vitamin D deficiency, kidney disease, hypoparathyroidism; >10.2 mg/dL indicates hypercalcemia from hyperparathyroidism, malignancy, excess vitamin D; ionized calcium more accurate than total; corrected calcium calculated in hypoalbuminemia
    • Uric Acid Elevation: >7.2 mg/dL in males or >6.0 mg/dL in females raises gout risk, metabolic syndrome, kidney disease; in diabetics correlates with insulin resistance and cardiovascular risk; low uric acid (<2.0 mg/dL) suggests xanthine oxidase deficiency or uricosuric drugs
    • Total Cholesterol ≥240 mg/dL significantly increases cardiovascular risk in diabetics; 200-239 mg/dL borderline and warrants lifestyle modification; diabetics should aim for <200 mg/dL ideally; level influenced by age, diet, genetics, medications
    • LDL >160 mg/dL indicates high cardiovascular risk; diabetics should target LDL <70 mg/dL (very high risk) or <100 mg/dL (standard); LDL particle size and density matter (small dense particles more atherogenic); LDL calculated as (TC - HDL - Triglycerides/5)
    • HDL <40 mg/dL in males or <50 mg/dL in females is independent cardiovascular risk factor; each 1 mg/dL increase reduces risk ~2%; higher HDL protective even with elevated LDL; low HDL associated with insulin resistance and metabolic syndrome
    • Triglycerides ≥200 mg/dL (2.0 mmol/L) are independent cardiovascular risk factor and associated with small dense LDL; very high triglycerides (≥500 mg/dL) risk acute pancreatitis; triglycerides raised by high carbohydrate diet, obesity, alcohol, poorly controlled diabetes
    • VLDL Elevation >40 mg/dL suggests hypertriglyceridemia and metabolic dysfunction; VLDL particles pro-atherogenic; correlates with insulin resistance
    • Total/HDL Ratio <5.0 is desirable; >5.0 indicates increased cardiovascular risk; lower ratios with same total cholesterol preferable; important prognostic marker
    • LDL/HDL Ratio: Optimal <2.0; 2.0-3.0 desirable; >3.0 indicates increased cardiovascular risk; provides better prognostic value than LDL alone
    • Non-HDL >130 mg/dL indicates excess apoB-containing particles (LDL + VLDL); particularly useful when triglycerides elevated as more accurate than LDL; target <130 mg/dL for diabetics
    • TSH >4.0 mIU/L suggests primary hypothyroidism; <0.4 mIU/L suggests hyperthyroidism or overtreatment; abnormal TSH with normal free T4 suggests subclinical thyroid disease; hypothyroidism impairs glucose control and increases hypoglycemia risk
    • Total T3/T4 Abnormalities: Low T3 syndrome in severe illness; elevated free T3 with low TSH suggests Graves disease; pattern helps differentiate primary thyroid disease from pituitary/hypothalamic disease
    • HbA1c ≥6.5% confirms diabetes diagnosis; <5.7% is normal; 5.7-6.4% indicates prediabetes requiring lifestyle intervention; lower HbA1c targets (<7%) recommended for many diabetics to reduce complications; targets individualized by age, duration, and comorbidities; elevated HbA1c despite normal fasting glucose indicates postprandial hyperglycemia
    • eAG Interpretation: Calculated as (28.7 × HbA1c) - 46.7 in mg/dL; provides glucose equivalent of HbA1c; eAG 130 mg/dL corresponds approximately to HbA1c 6.5%; useful for patient education; less accurate at extremes of hemoglobin or in hemoglobinopathies
    • Amylase Elevation >110 IU/L suggests pancreatitis, though not specific (also elevated in parotitis, intestinal disease); amylase peaks and normalizes within 3-5 days in acute pancreatitis; chronic pancreatitis may have normal amylase; useful for acute presentation
    • Lipase Elevation >60 IU/L more specific than amylase for pancreatic injury; elevated longer than amylase (persists 8-14 days); lipase >3× upper limit suggests acute pancreatitis; must be interpreted with clinical presentation and imaging
    • Hemoglobin <12 g/dL in females or <13.5 g/dL in males indicates anemia; severity determines clinical significance; mild anemia often asymptomatic but affects oxygen delivery; causes include iron deficiency, B12/folate deficiency, chronic disease, hemolysis
    • Hematocrit <36% in females or <41% in males indicates anemia; percent change important for monitoring; rapid decline suggests acute bleeding or hemolysis; gradual decline suggests chronic anemia from nutritional deficiency or chronic disease
    • RBC Count <4.1 million/mcL in females or <4.5 million/mcL in males indicates anemia; indices (MCV, MCH, MCHC) determine type (microcytic, normocytic, macrocytic); helpful for etiology of anemia
    • WBC >11,000 suggests infection, inflammation, leukemia, or stress; <4,500 indicates leukopenia from bone marrow disease, medications, autoimmune disease; differential count identifies specific leukocyte abnormalities
    • Platelets <150,000 indicates thrombocytopenia increasing bleeding risk; >400,000 suggests thrombocytosis from inflammation, myeloproliferation, or iron deficiency; affects wound healing and infection risk
    • Sodium <136 mEq/L indicates hyponatremia from SIADH, medication, or dilution; >145 mEq/L indicates hypernatremia from dehydration or inadequate water intake; affects neurologic function, osmolality, and fluid balance
    • Potassium <3.5 mEq/L indicates hypokalemia from diuretics, diarrhea, or medications; >5.0 mEq/L indicates hyperkalemia risking arrhythmias and muscle weakness; critical in diabetics on ACE inhibitors/ARBs; affects cardiac conduction
    • Chloride <98 mEq/L suggests hypochloremia from vomiting, loop diuretics, or metabolic alkalosis; >107 mEq/L indicates hyperchloremia from diarrhea or metabolic acidosis; maintains electroneutrality
  • Associated Organs
    • Microalbumin: Kidneys - Assesses glomerular filtration integrity; early marker of diabetic nephropathy before decline in GFR; complications include progressive renal failure, end-stage renal disease, hypertension, cardiovascular disease
    • C-Peptide: Pancreas (beta cells) - Reflects endogenous insulin production from beta cell secretion; affected by diabetes type and duration; indicates residual beta cell function and prognosis
    • Iron Studies: Liver (primary storage), bones (marrow), GI tract - Iron metabolism affects multiple organs; hemochromatosis causes liver cirrhosis, cardiomyopathy, diabetes, arthropathy; iron deficiency affects oxygen delivery and immune function
    • Liver Function Tests: Liver - Assesses hepatocellular function, synthetic capacity, and cholestasis; complications of abnormal LFTs include fatty liver disease (NAFLD), cirrhosis, acute hepatitis, liver failure, variceal bleeding
    • Kidney Profile: Kidneys (primary) - Assesses glomerular filtration rate, tubular function, and electrolyte regulation; complications of chronic kidney disease include hypertension, anemia, bone disease, cardiovascular disease, progression to ESRD requiring dialysis
    • Lipid Profile: Liver (synthesis), intestines (absorption), blood vessels (deposition) - Assesses cardiovascular risk; abnormalities contribute to atherosclerosis, myocardial infarction, stroke, peripheral arterial disease, sudden cardiac death
    • Thyroid Profile: Thyroid gland (primary), pituitary (TSH regulation) - Assesses thyroid function and autoimmunity; thyroid disorders affect glucose metabolism, metabolic rate, lipid profile; autoimmune thyroiditis common in Type 1 diabetes
    • HbA1c/eAG: Red blood cells (measured in RBC) - Reflects glucose control at tissue level; complications of persistent hyperglycemia include microvascular (retinopathy, nephropathy, neuropathy) and macrovascular (MI, stroke, PVD) disease
    • Insulin: Pancreas (beta cells), liver (metabolism), adipose tissue (receptor action) - Central to glucose homeostasis; abnormalities lead to diabetes, metabolic syndrome, PCOS, obesity complications
    • Pancreatic Profile: Pancreas (acinar cells) - Assesses pancreatic inflammation and function; complications include acute pancreatitis (severe pain, hypovolemia), chronic pancreatitis (malabsorption, diabetes), pancreatic insufficiency
    • CBC: Bone marrow (production), blood (circulation), spleen (destruction) - Assesses hematopoiesis and immune function; abnormalities affect oxygen delivery, infection risk, bleeding tendency, wound healing, immune response
    • Serum Electrolytes: Kidneys (regulation/excretion), GI tract (absorption), adrenal glands (aldosterone) - Critical for fluid balance, cardiac conduction, neuromuscular function; abnormalities cause arrhythmias, muscle weakness, seizures, altered mental status
  • Follow-up Tests
    • Microalbumin: If abnormal, repeat urine collection to confirm; 24-hour urine protein quantification if persistently elevated; renal ultrasound to assess kidney echogenicity; referral to nephrology if eGFR <30 or rapid decline; screening for kidney disease should be annual in all diabetics
    • C-Peptide: If low despite hyperglycemia, confirms Type 1 diabetes or advanced Type 2; if high with elevated glucose, indicates insulin resistance requiring lifestyle intervention and possible pharmacotherapy; can be repeated to track beta cell loss
    • Iron Studies: If transferrin saturation >50%, perform liver biopsy or MRI to assess for cirrhosis; screen first-degree relatives; repeat testing annually; if iron deficiency confirmed, investigate for GI bleeding; iron supplementation if deficient; consider phlebotomy if hemochromatosis diagnosed
    • Liver Function Tests: If ALT/AST elevated, repeat to confirm; ultrasound or FibroScan to assess fatty liver and fibrosis; if GGT/ALP disproportionately elevated, obtain right upper quadrant ultrasound for biliary obstruction; check viral hepatitis serology if indicated; referral to hepatology if concerning for cirrhosis
    • Kidney Profile: If abnormal, repeat in 2-4 weeks to confirm; measure 24-hour urine protein; renal ultrasound if eGFR <30; refer to nephrology if rapid decline or eGFR <30; assess for contrast-induced nephropathy if procedures planned; monitor annually in all diabetics; adjust medication doses for renal function
    • Lipid Profile: If abnormal, repeat fasting lipid panel in 4-12 weeks if lifestyle modifications initiated; assess 10-year cardiovascular risk using Framingham or ASCVD calculator; consider advanced lipid testing (particle size, Lp(a), apoB); start statin therapy if LDL elevated or diabetes present; monitor every 1-3 years if stable on therapy
    • Thyroid Profile: If TSH abnormal, measure free T4 to characterize dysfunction; if free T4 abnormal, check thyroid antibodies (TPO, thyroglobulin) for autoimmune thyroiditis; repeat TSH annually if subclinical hypothyroidism; screen for thyroid disease every 1-5 years in Type 1 diabetes; initiate levothyroxine if TSH >10 or <0.1
    • HbA1c: Retest every 3 months if <7% target not achieved; every 6 months if at goal and stable; annual in stable patients; eAG correlates glucose control with complications; home glucose monitoring if HbA1c >8%; continuous glucose monitoring if HbA1c >8% or frequent hypoglycemia
    • Insulin: Calculate HOMA-IR if concerned about insulin resistance (fasting insulin × fasting glucose / 405); if elevated, intensify lifestyle modifications; consider GLP-1 agonists or SGLT2 inhibitors; reassess after lifestyle changes or medication initiation
    • Pancreatic Profile: If amylase or lipase elevated, repeat measurement to establish trend; abdominal ultrasound or CT if pancreatitis suspected; lipase >3× upper limit warrants imaging; evaluate for choledocholithiasis, hypertriglyceridemia, alcohol use; hospitalize if acute pancreatitis confirmed
    • CBC: If hemoglobin low, measure iron studies and B12/folate; reticulocyte count to assess bone marrow response; peripheral smear for cell morphology; if WBC elevated, repeat to confirm; if WBC <4,500, repeat and consider hematology referral; monitor platelet trend
    • Electrolytes: If abnormal, check for dehydration, medication effects, or underlying disease; obtain ECG if potassium <3.0 or >6.0; hyponatremia workup includes serum osmolality and urine osmolality; repeat measurement acutely if severe abnormalities; urgent intervention if symptoms present
  • Fasting Required?
    • YES - Fasting for 8-12 hours is required for the Advanced Diabetic Package
    • Fasting Duration: 8-12 hours recommended; ideally 10 hours overnight fasting; 8-10 hours minimum acceptable; longer than 12 hours not necessary and may affect some results
    • Fasting Components: No food or calorie-containing beverages; water allowed; black coffee or tea without milk/sugar acceptable; no juice, sports drinks, or energy drinks; avoid chewing gum (contains sugar/non-nutritive sweeteners affecting results)
    • Medications: Continue all regular medications unless specifically instructed otherwise; inform phlebotomist of all medications; some medications affect test results (metformin for renal function, lipid-lowering drugs, corticosteroids); discuss with physician if medication effects concern you
    • Insulin Administration: Continue insulin injections/infusions as scheduled; do NOT skip doses; inform lab technician if insulin given to allow for proper test interpretation
    • Exercise: Avoid strenuous exercise 24 hours before testing; excessive activity can raise liver enzymes and affect glucose results; light activity acceptable
    • Alcohol: Avoid alcohol for 24 hours before testing; alcohol affects liver enzymes, lipids, glucose, and electrolytes; interferes with test interpretation
    • Stress: Minimize stress before blood draw; stress hormones affect glucose, cortisol, and CBC results; arrive early to reduce testing anxiety
    • Timing: Schedule blood draw in morning (7-9 AM) if possible; fasting state most pronounced in early morning; afternoon testing acceptable if 8+ hour fasting maintained
    • Urine Microalbumin: May require 24-hour urine collection (confirm with lab); if collecting, start collection in morning after first void (discard), collect all urine for 24 hours, end collection with first morning void next day; refrigerate collection; transport promptly
    • Special Circumstances: If diabetic and taking insulin/medications for hypoglycemia, consult physician about testing day management; have carbohydrate source available after testing; women should avoid testing during menstrual cycle if possible (can affect CBC); report fever, infections, or recent illness to phlebotomist

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