Laboratory tests to manage Type 1 diabetes

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Type 1 diabetes is a chronic condition. It therefore requires regular monitoring to check glucose control and also to detect – and, above all, prevent – any complications. So blood tests are an integral part of Type 1 diabetes management.  

Glycated hemoglobin (HbA1c)

HbA1c or glycated hemoglobin corresponds to the percentage of hemoglobin in the blood with sugar attached to it. This percentage increases along with blood sugar levels. The A1C test, as it is more commonly known, is very useful for management. It provides an average measurement of blood glucose over the 3 months prior to the blood test. Ideally, the HbA1c should be below 7.5% but the target varies depending on the patient. HbA1c levels that are too high signal diabetes that is poorly controlled, making the patient more likely to develop complications

HbA1c tests are now tending to be replaced by HbA1c levels calculated by continuous glucose monitoring (CGM) systems, based on measurement of glucose levels every 5 minutes.

Cholesterol: good or bad?

To analyze cholesterol, physicians use a test called a “lipid panel”. The substances measured are “good” cholesterol (HDL), “bad” cholesterol (LDL) and another type of lipid (or fat), triglycerides. 

Although these fats are all essential to the body, too much of the bad kind of cholesterol – LDL cholesterol – can cause heart disease or strokes. This hypercholesterolemia aggravates diabetes-related damage to the arteries, especially in patients who are overweight or have high blood pressure. That’s why regular cholesterol testing is essential in every person living with Type 1 diabetes.     

Monitoring of kidney function

The kidneys are the body’s filters. If a kidney is damaged, it allows small amounts of protein to pass through, especially albumin, a large protein that is not meant to be filtered and should remain in the blood. The presence of albumin in the urine is therefore a very good indicator of impaired kidney function. But beware: the initial deterioration of kidney function has no symptoms. 

Blood creatinine levels, which is the concentration in the bloodstream of creatinine – a substance normally eliminated by the kidneys – are also useful to assess kidney health. An increase in blood creatinine is a sign of a deterioration in kidney function. 

Therefore the regular tests performed in people with Type 1 diabetes include measurement of blood creatinine and screening for albumin in the urine (microalbuminuria test). Even if the tests present an anomaly, action may still be taken as there are currently known ways to protect the kidneys.

Type 1 diabetes and thyroid problems

Type 1 diabetes may be associated with other autoimmune diseases. These include thyroid gland conditions: hypothyroidism (under-active thyroid) and hyperthyroidism (overactive thyroid). These thyroid problems are commonly associated with Type 1 diabetes, which explains why tests are performed to monitor TSH, the hormone that regulates the production of thyroid hormones. TSH levels vary in the event of hyper or hypothyroidism and are an indicator of associated thyroid damage. If this is the case, treatments are available to restore the hormonal balance. 

It is important to note that the tests ordered by the doctor are just part of the diabetes management process. Blood pressure and weight changes are also closely monitored and other tests specific to the individual patient may be prescribed. It is essential to know and understand how to monitor Type 1 diabetes so that you can take care of yourself properly. With the help of your doctor, you can not only prevent diabetes complications, you can also make sure you have a very healthy lifestyle.

Summary – Routine tests

A1C testing¹:

  • Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals.
  • Point-of-care testing for HbA1c levels provides the opportunity for more timely treatment changes.
  • Lipid panel (total cholesterol, HLD-C, LDL-C, triglycerides) – initial test, then annually
  • Blood creatinine and glomerular filtration rate – initial test then annually in the absence of kidney damage, as required in the event of chronic kidney disease
  • Screening for microalbuminuria in a urine sample – initial test then annually in the absence of kidney damage, as required in the event of chronic kidney disease

¹American Diabetes Association –

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