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Diabetes

Diabetic blood test

04/28/2008

Question:

I have type 2 diabeties. I have been having some aches in my right lower leg. And have some swelling in the ankles and feet. I had blood work done. But having a hard time trying to get my doctor to talk to me about it. It has been over a week now. I was just want someone to tell me what the test all meant. My Co2 is 31, Glu is 168, Crea is .53, and HbA1C% is 14.00 Can you tell me what all this means. I already know that I need to increase my insulin. But like I said. I cant get my doctor to return my calls. I had a Basic Metabolic Panel done and those were the ones that were either high or low. If you can help I would appreciate it.

Answer:

The first questions are 1) whether the ache in the leg is truly an ache or whether it has some different quality, how long it has been there and whether it is getting better or worse; 2) similar questions about the ankle swelling. Those are what will determine whether there is an urgent problem that needs to be addressed, or whether to focus on the lab work. In terms of the lab work, the key finding is the markedly elevated HbA1c. That means that the overall blood sugar control has not been good for quite some time; perhaps you need a change in the insulin or perhaps you need to take a different, more intensive approach to lifestyle matters including what you eat and how active you are. The glucose is a confirmation of the same issue. I wouldn't be terribly concerned at this point about the CO2 (a measure of the bicarbonate level in the blood which in turn is an indicator of acid regulation) or the creatinine which is a measure of kidney function (a low creatinine is not usually a concern except when there is malnutrition or some other unusual causes).

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati