Diabetes: Diagnosis, Laboratory Testing, and the Current American Diabetes Association Guidelines
Continuing Education Credits
Diabetes is a national and international healthcare issue due to its high incidence and healthcare costs. The diabetic patient is at risk for many serious complications and may experience a diminished quality of life. This course will primarily focus on recommendations made by the American Diabetes Association (ADA) that are related to the diagnosis and monitoring of diabetes. Three case studies are followed throughout the course as laboratory tests are chosen that will lead to a probable diagnosis based on the recommendations of the ADA. Recommended tests for monitoring diabetic patients are also discussed.
Objectives
- Define diabetes and differentiate between type 1 and type 2 diabetes.
- Discuss gestational diabetes and other causes of diabetes.
- Explain the role of the clinical laboratory in the diagnosis and monitoring of diabetes.
- Discuss the signs and symptoms of diabetes.
- List the common ways to prevent, manage, and treat diabetes.
- Identify clinical and laboratory criteria that indicates increased risk for diabetes.
- List the current assays used to monitor diabetic patients.
- Explain the recommendations made by the American Diabetes Association in regards to diagnosis and monitoring of diabetes.
- Explain the recommendations made by the American Diabetes Association in regards to diagnosis and monitoring of diabetes.
- Explain the recommendations made by the American Diabetes Association in regards to diagnosis and monitoring of diabetes.
Course Outline
- Overview of Diabetes: Definition and Facts
- Organizations and Agencies
- Definition
- Which of the following statements about insulin is incorrect?
- Facts
- A Metabolic Disorder
- True or False: There is an emerging global epidemic of diabetes that has been traced to rapid increases in overweight people, including obesity and physical inactivity.
- Blood Glucose and Hormonal Control
- Blood Glucose and Hormonal Control
- Blood Glucose and Hormonal Control, continued
- Blood Glucose and Hormonal Control, continued
- What is the metabolic process whereby glycogen is broken down or hydrolyzed in the liver into glucose which is released into the bloodstream?
- Which statement is true about the regulation of normal blood glucose?
- Which of the following hormones is mainly responsible for the entry of glucose into the cell for energy production?
- Classification of Diabetes
- The Four Clinical Classes of Diabetes
- Which of the following statements is incorrect about the clinical classes of diabetes?
- Type 1 Diabetes
- Type 2 Diabetes
- Type 2 Diabetes: Prediabetes
- True or False: Type 2 diabetes was formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes and most often occurs in childhood or young adult years. Type 2 represents about 10% of diabetic cases.
- When is Diabetes Classified as Type 1 or Type 2?
- Gestational Diabetes (GDM)
- Diabetes Due to Other Causes
- Which of the following statements correctly describes gestational diabetes (GDM)?
- Risk, Complications, and Management of Diabetes
- Signs and Symptoms
- Risk Factors and Complications
- Treatment and Management
- Treatment and Management, continued
- The initial early sign of diabetes is hyperglycemia. More significant hyperglycemia can cause all of the following except:
- True or False: Ketoacidosis is a serious complication for type 1 diabetics and results in the production of excess acetyl CoA which is converted to ketone bodies.
- Which of the following patients is most at risk for hyperosmolar nonketotic coma?
- Screening for Diabetes and Updated ADA Guidelines
- American Diabetes Association (ADA) Guidelines: Update
- ADA Guidelines: Criteria for Prediabetes and Diabetes Diagnosis
- ADA Guidelines: Screening for Diabetes and Prediabetes in Asymptomatic Adults
- ADA Guidelines: Considerations for Type 2 Diabetes or Prediabetes in Asymptomatic Children and Adolescents
- ADA Guidelines: Screening for Type 2 Diabetes or Prediabetes in Asymptomatic Children and Adolescents
- ADA Guidelines: Categories of Increased Risk for Diabetes (Prediabetes)
- ADA Guidelines: Monitoring Glycemic Control Using Hb A1C
- ADA Guidelines: Diabetes Screening for Pregnant Individuals
- Which test/result combination meets the ADA criteria for diabetes diagnosis?
- True or False: A patient's Hb A1C level of 6.0% would be considered an increased risk for diabetes (prediabetes).
- Which statements are true regarding the testing and diagnosis of gestational diabetes (GDM)?
- Laboratory Assays in Evaluating Diabetic Patients
- Clinical Laboratory Testing
- Blood Glucose Testing
- Whole Blood Glucose Testing
- Urine Glucose
- Urinary Albumin
- Ketones
- Insulin and C-Peptide
- Insulin Antibodies
- How do whole blood glucose values correlate to plasma glucose values?
- Which laboratory test is used to identify early renal impairment in diabetic patients?
- Glycated Proteins and Hb A1C
- Hb A1C versus Blood Glucose Measurement
- Fructosamine
- Oral Glucose Tolerance Test (OGTT)
- Continuous Glucose Monitoring (CGM)
- True or False: The A1C test can be used as an index relating the extent of carbohydrate control during a two- to three-month period.
- What is the ADA recommendation for the use of continuous glucose monitoring (CGM) technology?
- What is one of the most common methods used to quantify blood glucose levels?
- Estimated Average Glucose (eAG)
- Estimated Average Glucose
- The formula for conversion of Hb A1C to glucose in mg/dL is:Estimated average glucose (eAG) = 28.7 x A1C – 46.7The Hb A1C measured on a patient is reported as 7.5%. What would the eAG be reported as for this patient?
- Case Studies in Diabetes
- Case Studies
- Case A
- Case B
- Case C
- From the three cases, which patient(s) would be diagnosed with diabetes according to the criteria for diagnosis?
- Which of the following statements is most accurate regarding the patient in case A?A 50-year-old patient with a family history of diabetes visits the physician for a routine physical. The patient reports that they feel their health is excellent. The patient exercises regularly, but often their diet is high in calories and fat.Physical Examination:Slightly overweight; blood pressure and pulse norma
- The Laboratory's Role in Diabetes
- The Laboratory's Role in Diagnosis and Monitoring of Diabetes
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists and technicians, and other health care personnel who have an interest in this subject matter. This course is also appropriate for medical laboratory science students and pathology residents.
Author Information:
Mary Ellen Koenn, MS, MLS(ASCP) is an associate professor emeritus at West Virginia University School of Medicine, Medical Laboratory Science Program. During her career as a medical technologist and educator, she has been a laboratory supervisor and manager and has held several teaching positions. She is the author of numerous articles for laboratory publications and textbook chapters and is a frequent presenter at laboratory seminars and workshops. Mary Ellen Koenn holds a Master of Science degree in Medical Technology.
David J. Moffa, PhD, BCLD, has over 30 years of experience in the healthcare industry as an executive manager, clinical laboratory director, and medical laboratory scientist. He is currently a technical consultant for Kentmere Healthcare, Wilmington, DE, and until his retirement, was the Regional Director for LabCorp, Inc. He holds a PhD in medical biochemistry from the School of Medicine at West Virginia University.
Reviewer Information: Laurie
Bjerklie, MA, MLS(ASCP)CM is currently an Education Developer
for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from
the University of North Dakota and an M.A. in Curriculum and Instruction from
Saint Xavier University. She has over 15 years of experience in higher
education and has held program director and faculty positions in both MLT and
MLS programs.