Laboratory findings in diabetes mellitus
1 - Hyperglycemia
- Glucose level may exceed 200 mg/ dl or more
- When the level of blood glucose exceed the renal threshold , glucose will descend in the urine causing glucosuria .
2 - Lipemia and Ketonemia
- When glucose utilization diminished in diabetic animals , metabolism turns to utilization of fatty acids as a source of energy .
- Mobilization of body fat occurs and utilization by the liver .
Lipemia occurs due to excessive mobilization of fat .
- Ketone bodies accumulates in the blood and then descend in the urine , so that ketonemia is followed by ketonuria and usually occurs in the advanced stages of diabetes and accompanied with blood acidosis .
3 - Cholesterol level
- Hypercholesterolemia , which indicate chronicity and severity of the disease ( it may reach 300- 900 mg/dl ) .
4 - Acidosis
- Vomiting occurs due to the accumulation of ketone bodies in the blood and acidosis leads to loss of potassium , sodium and chloride .
- Decrease of bicabonates and P co2 due to hyperpnoea .
5 - Electrolytes balance
- Sodium and potassium are also lost by renal excretion of acetoacetic acid and beta hydroxy butyric acid , which are strong acids
- Hyperkalemia may occur terminally due to severe acidosis .
6 - Dehydration
- Dehydration and acidosis may result in collapse and coma .
7 - Hemogram
- Leukocytosis may occur when when there is concurrent infection .
- Hemolysis of blood is frequently present in the lipimic blood due to increase susceptibility of the erythrocytes to hemolysis when achylomirca present in large number .
- Eosinopenia and lymphopenia indicating stress
8 - Serum enzyme activity
- Amylase enzyme increase when there is a cute pancreatitis associated with the case
- ALT& AP increased due to fatty metamorphosis of the liver .
9 - Blood - urea nitrogen and serum creatinine levels
- Uremia occurred frequently due to dehydration ( pre-renal uremia )
- BUN & creatinine usually increase in cases where renal failure is developed in advanced cases of diabetes mellitus and they measured for for prognostic purposes
10 - Increased glycosylated hemoglobin
- Diabetic patients that are on a long term of insulin therapy should be monitored on a regular basis . The use of glycosylated hemoglobin has been recommended .
- The rate of glycosylation of hemoglobine depends up on the nature and concentration of carbohydrates in the erythrocytes over a time .
- Because erythrocytes are insulin - independent cell , intracellular glucose increases as plasma glucose rises
- Glycosylated hemoglobin is in low concentration in red cells of clinically normal cases and is found in increased amounts in patients with uncontrolled diabetes
- The level of glycosulated hemoglobin indicates blood glucose level over the previous 2 - 3 weeks before measurements .
11 - Urinalysis
a- Glucosuria
b - Polyuria
c - Increased specific gravity of the urine due to glucose
( 0.004 units of sp. gr is increased for each gram /dl of urine ) , So that increases in the sp, Gr is minimal and affected by amount of water intake .
d - Ketonuria occurs in the advanced diabetes and not detected in mild cases of diabetes .
e - Proteinuria : I t is observed in the diabetic patients with uncontrolled blood glucose level and changes in the basement memberan in the kidney glomerulus have occured . U rine casts may be observed in the animals with protienuria .
f - Anuria can be occurred in seriously ill diabetic patients .