Type 2 Diabetes: Diagnosis

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Type 2 Diabetes: Diagnosis
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Also known as: Fasting lipid profile (total cholesterol, HDL cholesterol, triglycerides, and LDL cholesterol).

What is it? A blood test that measures the total cholesterol, HDL and LDL cholesterol levels, and triglyceride levels in the bloodstream.

Why is this test performed? To assess the risk for the development of coronary artery disease, the leading cause of death among people with diabetes in the U.S. It is also used to diagnose dyslipidemia, a condition characterized by the high triglyceride and cholesterol levels that can be caused by diabetes, particularly poorly controlled diabetes.


How frequently should this test be performed? The ADA recommends that the fasting lipid panel be performed annually for most diabetes patients. If you are working with your physician to control lipid levels through medication or diet, testing may be done more frequently. However, the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) recommend that a fasting lipid profile be obtained during an initial assessment, each follow-up assessment, and annually as part of the cardiac-cerebrovascular-peripheral vascular module. 1

What is the "normal" range for results? Cholesterol levels vary by medical history, gender, age, ethnicity, and geographic region, but the National Cholesterol Education Program recommends an average target total cholesterol of under 200 mg/dl and triglyceride values of approximately 150 mg/dl or less.

NCEP guidelines also call for HDL (or good) cholesterol of at least 40-60 mg/dl and LDL (or bad) cholesterol of 129 or less. High-risk patients, which includes those with diabetes, should keep LDL at less than 100 mg/dl. The ADA recommends that people with diabetes keep triglycerides under 200 mg/dl, HDL cholesterol over 45, and LDL cholesterol under 100 mg/dl.

In 2004, the NCEP issued new guidelines for patients considered at "very high risk." Patients are considered at very high risk if they already have cardiovascular disease plus diabetes, are smokers, have poorly controlled high blood pressure, have a history of heart attack, or have the metabolic syndrome. These patients may be treated to achieve a target LDL level of 70 mg/dl or less.

What do abnormal results mean? Moderately elevated triglyceride levels can indicate diabetes, but can also be caused by a host of other problems, including kidney and liver disease and alcoholism. High serum cholesterol levels can be triggered by poor dietary habits, pancreatitis, hypothyroidism, lipid disorders, and certain kidney and liver diseases. High LDL levels reflect an increased risk of coronary artery disease. Low HDL levels are indicative of cardiovascular risk. HDL is "good" cholesterol and high levels are desired. Elevated HDL levels may point to early liver disease, but can sometimes be found in healthy individuals.

1 United States. National Quality Measures Clearinghouse. Adult diabetes: percentage of patients receiving at least one lipid profile: 2003. 1 May 2003

Reviewed by Francine Kaufman, MD. 4/08


Last Modified Date: June 4, 2008


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