Analysis in the complications of diabetes mellitus

"Detecting a disorder such as diabetes in time can help avoid complications arising from its evolution over time".

DR. NEREA VARO CENARRUZABEITIA
SPECIALIST. BIOCHEMISTRY DEPARTMENT

Diabetes mellitus is mainly characterized by the presence of high concentrations of glucose in the blood (hyperglycemia) due to the alteration in the action of insulin or the absence of this hormone, which is produced in the pancreas to allow the capture of glucose by the tissues that use it as fuel.

The diabetic patient must know very well how diabetes is produced and what dietary and lifestyle measures must be taken to achieve good control of his or her disease.

There are short and long term complications; in order to control and prevent these complications, it is necessary to perform periodic analyses that indicate how the diabetes is evolving.

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When is a diagnosis of diabetes complications indicated?

There are chronic complications and acute complications that can aggravate the initial diagnosis of diabetes mellitus.

In both cases, however, there are analytical tests that can be used to evaluate the severity of the process and, in many cases, allow the diagnosis of the complications to be advanced by months and to avoid the appearance of new damage.

The treatment indicated by your doctor seeks to adequately control the diabetes. This is not always achieved with the desired effectiveness, which causes alterations in the organism that, maintained over time, can produce important complications in the medium to long term.

Most frequent indications of this test:

  • Diabetes mellitus type 1
  • Diabetes mellitus type 2
  • Gestational diabetes
  • Other types of diabetes

Do you have any of these diseases?

You may need to be tested for diabetes complications

Types of diagnostic tests for diabetes complications

Diabetic ketoacidosis: is a complication more typical of type 1 diabetes mellitus.

The lack of insulin or its low action allows the elevation of plasma glucose, which extracts water and dehydrates some tissues, while appearing in urine, for exceeding the threshold of renal recovery.

The dehydration caused, as well as the high concentration of solutes in plasma can introduce the patient into a comatose state due to hypovolemic shock, with more or less pronounced lactic acidosis.

Hyperglycemic decompensation: it occurs more in older type 2 diabetics, in whom dehydration can slowly develop and its effect can be attributed to other causes. 

Lactic acidosis: in diabetes with which circulatory problems, heart or respiratory failure or anemia coexist. It is determined by the acid-base balance, lactic acid and glucose.

Hypoglycemic coma: due to excessive dosage of insulin or hypoglycemics for the real organic need. It is determined by glucose.

Microangiopathy: is the damage of the wall of small vessels by protein glycosylation. The process especially affects the retina and kidney.

In the retina, it leads to the appearance of vascular buds, increased vascularization of the area, local hypoxia and edema, with consequent cell damage, which can lead to blindness.

In the kidney, microangiopathy manifests itself in damage to the renal glomerulus and progressive excretory failure.

Analytically, the amount of glycation is followed by glycosylated hemoglobin or fructosamines (total glycosylated product of plasma proteins). Hemoglobin, with a half-life of 120 days, is irreversibly glycosylated depending on the glycaemia to which it is exposed. Normally, less than 7% of hemoglobin is glycosylated, but in states of hyperglycemia this proportion increases, so that in the periodic follow-up of the diabetic, its determination quantifies the average glycemia during the last two or three months, while the glycemia reflects only the present moment and not how it was yesterday.

Macroangiopathy: affects the wall of large vessels and is an atherosclerotic process caused by the hormonal imbalance of diabetes mellitus, the glycosylation of lipoproteins and receptors and the lipidic alteration that frequently accompanies diabetes.

Analytically its main manifestation is the alteration of cholesterol control, with elevated values generally based on cholesterol associated with low density lipoproteins (LDL-cholesterol), which constitutes the improperly called "bad cholesterol".

Where do we do it?

IN NAVARRE AND MADRID

The Clinical Biochemistry Service
of the Clínica Universidad de Navarra

The Clinical Biochemistry Service of the Clinica Universidad de Navarra is responsible for performing the biochemical analyses requested by the medical specialists of our center.

We carry out technical quality controls to guarantee the proper functioning of the equipment and the highest precision in the results obtained from the samples.

In order to guarantee excellence in patient service, we offer the response with the results of the analyses in the shortest possible time, responding in only 46 minutes in some cases of general analysis.

Organized in care units

  • General biochemistry.
  • Electrolytes.
  • Hormones, urine and proteins.
  • Markers.
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Why at the Clinica?

  • Maximum speed in offering the analytical results.
  • We carry out quality controls to guarantee the correct and most precise results obtained.
  • We work in a multidisciplinary way with all the departments of the Clinic.