Diabetes Risk: Interpreting Your Blood Test Results - Internal Medicine

Dr. Xiao Yongxun reply Internal Medicine

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1.
Your fasting blood test report shows an average red blood cell volume of 78.5, hemoglobin of 24.6, high-sensitivity C-reactive protein of 10.58, glycated hemoglobin (HbA1c) of 7.7, GOT (AST) of 86, GPT (ALT) of 172, alkaline phosphatase of 110, total iron binding capacity of 540, high-density lipoprotein cholesterol (HDL-C) of 35, non-high-density lipoprotein cholesterol (non-HDL-C) of 139, insulin of 19.8, and C-peptide insulin of 4.80.
During formal discussions, it is important to include units to avoid misunderstandings.
Additionally, with numerous test items, the clinical purpose is to assist in diagnosing specific diseases.
Tests, imaging studies, and various assays are fundamentally used to confirm clinical diagnoses; one should not reverse this process by conducting many tests and then speculating on possible diagnoses.
2.
To determine whether the above values are elevated or decreased, it is best to refer to the reference values provided by the specific laboratory, as testing methods or laboratories may differ.
This is particularly true for commonly used clinical tests.
Note: a.
GOT (AST) of 86 and GPT (ALT) of 172 may be elevated, indicating possible hepatitis, with common causes including hepatitis B, hepatitis C, alcoholic liver disease, fatty liver, drug-induced hepatitis, gallstones, etc.
b.
The high-sensitivity C-reactive protein level may be elevated, indicating a significant inflammatory response in the body, commonly due to infections, inflammatory responses related to atherosclerosis, etc.
c.
The high-density lipoprotein cholesterol level may be low, commonly due to lack of exercise, excessive intake of high-sugar and high-fat foods or beverages, etc.
d.
The non-high-density lipoprotein cholesterol level likely refers to low-density lipoprotein cholesterol (LDL), which may be elevated, commonly due to excessive intake of trans fats, high-cholesterol foods, lack of exercise, etc.
e.
Insulin or C-peptide insulin levels appear acceptable, but it is advisable to compare them with the laboratory's reference values.
f.
The assessment of red blood cell values must be considered holistically; one cannot make a judgment based solely on two values (average red blood cell volume and hemoglobin).
3.
According to the American Diabetes Association's diagnostic criteria for diabetes: a.
Fasting plasma glucose ≥126 mg/dL after 8 hours or more, b.
Oral glucose tolerance test 2-hour plasma glucose ≥200 mg/dL, c.
HbA1c ≥6.5% (must not have any disproportionate hyperglycemia and the testing method must meet international certification standards NGSP and DCCT), and the above a, b, c conditions must be confirmed on two separate occasions.
d.
If there are clinical symptoms of diabetes (such as polydipsia, polyuria, polyphagia, weight loss, etc.), any plasma glucose level ≥200 mg/dL is sufficient (this condition only needs to be met once).
4.
Therefore, you currently do not have related symptoms, your weight has not changed, and you do not experience increased urination or increased eating or drinking.
The only test result indicating HbA1c is 7.7%, and there is a lack of blood glucose values.
Thus, it can only be said that you are very likely to have diabetes.
On the other hand, you mentioned using a biologic agent; what specific biologic agent is it? Why are you using it? What are its components? How long have you been using it? Whether it could interfere with diabetes diagnosis remains to be discussed.
5.
Please discuss your test results in detail with the physician who ordered them or your family doctor before making any decisions.

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Reply Date: 2015/12/31