LABORATORY RESULTS INTERPRETATION

I wrote about laboratory results reliability and interpretation only recently.

I started my clinic yesterday. Here is an example from a patient I saw yesterday for the first time. The spouse who I had seen for the first time before I left Mauritius in August decided to do the same monitoring for her too.

Here are the results. You can see from the laboratory results that HbA1C IS 5.5% ( NORMAL).
HbA1C is a test which tells you your average level of blood sugar over the past 3 months. Normal values are less than 5.7% and diabetes is more than 6.5%. The patient's results is completely normal, not even pre-diabetetic.

Now look at the home blood glucose levels in the morning (fasting). It varies between 5.9- 7 mmol/L. Most of them are above 6 mmol/L and there are quite a few above 7.0 mmol/L, one even at 8/4 mmol/L ( unfortunately it appears blurred in the photo).

To diagnose someone with diabetes, you need either a HbA1C of more than 6.5% ( which is normal in this case), therefore she does not have diabetes. Another way to diagnose someone with diabetes, you need two fasting blood glucose above 7.0 mmol/L, which she has, meaning that she has diabetes.

So does she have diabetes or not?

Answer is YES, as she has more than 2 values of fasting blood glucose level.
If I we relied on the laboratory test results, then she would have been missed and may have presented when she developed complications possibly or when she would have become very symptomatic.

Lesson: one has to err on the side of caution and interpret results with caution.

By Dr. Iswaraj Ramracheya