Laboratory Testing for Diabetes Diagnosis and Management

This test guide discusses the use and interpretation of laboratory tests for diagnosing diabetes and monitoring glycemic control.

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Test Guide

This Test Guide discusses the use of laboratory tests for diagnosing diabetes mellitus, monitoring glycemic control in individuals with diabetes, and monitoring diabetic complications.

Diagnosis

Tools for diagnosing diabetes mellitus include fasting plasma glucose (FPG) measurement, oral glucose tolerance tests (OGTT), and standardized hemoglobin A1c (HbA1c) assays (Table 1).1-6 Clinically significant glucose and HbA1c levels are shown in Table 2.1 Generally, all 3 tests are equally appropriate for diagnostic screening, although one may be more appropriate than another depending on an individual’s characteristics (eg, due to nondiabetic illness or stage of pregnancy).1

FPG and OGTT tests are sensitive but measure glucose levels only in the short term, require fasting or glucose loading, and give variable results during stress and illness.1 In contrast, HbA1c assays reliably estimate average glucose levels over a longer term (2 to 3 months), do not require fasting or glucose loading, and have less variability during stress and illness.1,3 In addition, HbA1c assay results improve risk prediction for individuals at risk of developing type 2 diabetes mellitus.2

In some circumstances, HbA1c is a less reliable marker than plasma glucose. Examples include people with hemoglobinopathies (eg, sickle cell trait), increased red blood cell turnover (eg, hemodialysis or recent blood cell loss/transfusion), HIV, glucose-6-phosphate dehydrogenase deficiency, or cystic fibrosis, as well as during pregnancy (2nd and 3rd trimester) and the postpartum period.1,7 In addition, primary prevention measures have proven more efficacious for individuals whose glycemic status is based on OGTT results compared with isolated FPG results or HbA1c results meeting the criteria for prediabetes.1

The American Diabetes Association® (ADA) recommends using FPG, OGTT, and HbA1c for diagnosing diabetes and identifying increased diabetes risk (prediabetes). Screening for prediabetes and/or type 2 diabetes should be performed for all individuals beginning at age 35 years, earlier for those with risk factors (see Table 2.3 in Standards of Care in Diabetes—2023 Abridged for Primary Care Providers),8,9 HIV, pregnant individuals, and those planning pregnancy (Table 2).1 For overweight or obese children or adolescents with ≥1 risk factors, screening should be considered after the onset of puberty or after 10 years of age, whichever occurs earlier.1

For individuals with prediabetes, annual monitoring for development of diabetes is recommended; frequency of monitoring may be modified based on an individual’s risk-to-benefit assessment.1 For those without diabetes or prediabetes, screening should be repeated every 3 years.1

Management

Following a diagnosis of diabetes, a combination of laboratory and clinical tests can be used to monitor blood glucose control, detect onset and progression of diabetic complications, and predict treatment response. Recommended testing frequency and target results for these tests can be found in Table 3. 7,10,11 Different laboratory tests are available for monitoring blood glucose control over the short-, long-, and intermediate term to help evaluate the effectiveness of a management plan.

Blood glucose monitoring (BGM) and continuous glucose monitoring (CGM) are useful for tracking short-term treatment responses in insulin-treated patients, but their usefulness is less clear in non–insulin-treated patients.7,12 By contrast, the long-term HbA1c measure should be used as the primary test of glycemic control in all nonpregnant adults with diabetes7; lowering HbA1c levels by 1 percentage point reduces the risk of microvascular complications by approximately 40%.13 To help patients relate long-term glucose control to daily BGM measurements, HbA1c test results may be converted to conventional glucose units (mg/dL or mmol/L) and reported as the estimated average glucose (eAG).3-5,7

Alternatives to HbA1c testing for monitoring glycemic control over the intermediate term include fructosamine testing (2 to 3 weeks) and 1,5-anhydroglucitol (1,5-AG, 1 to 2 weeks) testing. Fructosamine testing is particularly useful when HbA1c may not be a reliable marker, such as in hemodialysis patients with high red blood cell turnover, early responses to treatment changes, and pregnancy complicated by diabetes.14 Levels of 1,5-AG are used to assess postprandial excursions in individuals with moderately or well-controlled HbA1c levels (6.5% to 8.0%).11,14 A 2020 study proposes that 1,5-AG be used to increase physician awareness of steroid-induced hyperglycemia and poor short-term glycemic control, which is associated with poorer outcomes.15 Levels of 1,5-AG have been found to be predictive of microvascular complications, independent of HbA1c, in patients undergoing glucose and blood pressure-lowering therapy.16 However, no current guidelines provide recommendations on how either fructosamine or 1,5-AG should be incorporated into clinical practice.7,14 Quest Diagnostics offers 1,5-AG testing, which can be used as suggested (Figure)11 in conjunction with HbA1c to identify individuals experiencing postprandial excursions over the short- to intermediate term. The 1,5-AG test is unreliable for patients taking SGLT2 inhibitors because of assay interference.17

Individuals with diabetes are at increased risk of heart and kidney disease, retinopathy, neuropathy, and nonalcoholic fatty liver disease (NAFLD). Routine eye and foot exams, along with blood pressure, lipids, urine albumin-creatinine ratio, creatinine/estimated glomerular filtration rate (eGFR), and liver function testing, are recommended to detect the onset and monitor progression of these complications (Table 4).6,18,19

Tables 1, 2, 3, and 4 are provided for informational purposes only and are not intended as medical advice. Test selection and interpretation, diagnosis, and patient management decisions should be based on the physician’s education, clinical expertise, and assessment of the patient.

Table 1. Tests Used in Diabetes Diagnosis and Management

Test code	Test name (panel components)	Primary clinical use and differentiating factors
10378	1,5-Anhydroglucitol (1,5-AG), Intermediate Glycemic Controla	Diabetes management—measure glycemic control over the intermediate term (1 to 2 weeks)
92027	Diabetes Risk Panel With Scoreb Includes glucose (483); HbA1c (496); total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896) with reflex to direct LDL (8293); cholesterol/HDL ratio (calculated); non-HDL (calculated); and 8-year risk of developing diabetes (calculated).	Diagnosis of prediabetes Calculate 8-year riskc for developing type 2 diabetes mellitus2
91920	Diabetes Risk Panel Without Scoreb Includes glucose (483); HbA1c (496); total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896) with reflex to direct LDL (8293); cholesterol/HDL ratio (calculated); and non-HDL (calculated).	Diagnosis of prediabetes Assess risk for developing type 2 diabetes mellitus Identifies patients suitable for lifestyle interventions and/or pharmacotherapy
91712	Diabetes, Newly Diagnosed and Monitoring Panelb Includes glucose (483); HbA1c (496); hepatic function panel (total protein [754], albumin [223], globulin [calculated], albumin/globulin ratio [calculated], total [287], direct [285], and indirect [calculated] bilirubin, alkaline phosphatase [234], AST [822], and ALT [823]); lipid panel (total [334], HDL [608], and LDL [calculated] cholesterol; triglycerides [896] with reflex to direct LDL [8293]; cholesterol/HDL ratio [calculated]; and non-HDL [calculated]); serum creatinine (375) with eGFR (calculated); and albumin, random urine with creatinine (6517) (includes albumin and creatinine, random urine 8459[X] and albumin/creatinine ratio [calculated]).	Diabetes management—establish baseline measurements for patients with a recent diagnosis of diabetes mellitus Monitor patients with diabetes mellitus
8340	Fructosamine	Diabetes management—measure glycemic control over the intermediate term (2 to 3 weeks)
8477	Glucose, Gestational Screen (50g), 135 Cutoff	Screen (without prior fasting) for gestational diabetes using a 1-hour (post 50-g glucose loading) specimen (ADA- and ACOG-supported 1st step of 2-step evaluation); a cutoff of 135 mg/dL (test code 8477) or 140 mg/dL (test code 19833) indicates that the 2nd step (test code 6745) is necessary
19833	Glucose, Gestational Screen (50g), 140 Cutoff
484	Glucose, Plasma	Diagnosis based on FPG
18927	Glucose Tolerance Test, Gestational, 3 Specimens (75g)	Diagnosis of gestational diabetes (ADA-supported 1-step evaluation)
35181	Glucose Tolerance Test, 2 Specimens (75g)	Diagnosis based on fasting and 2-hour (post 75-g glucose loading) specimens (2-hour OGTT)
23475	Glucose Tolerance Test, 3 Specimens (75g)	Diagnosis based on fasting, 1-, and 2-hour (post 75-g glucose loading) specimens
6745	Glucose Tolerance Test, Gestational, 4 Specimens (100g)	Diagnosis of gestational diabetes based on fasting, 1-, 2-, and 3-hour (post 100-g glucose loading) specimens (ADA- and ACOG-supported 2nd step of 2-step evaluation)
496	Hemoglobin A1cd	Diagnosis and management—determine long-term average blood glucose, expressed as a percentage.
16802	Hemoglobin A1c With eAGd	Diabetes management—determine long-term average blood glucose; expressed in percent HbA1c and calculated estimated average glucose (eAG) in conventional blood glucose units for more convenient comparison to BGM values.1,3-5
10380	Hemoglobin A1c With Reflex to 1,5-Anhydroglucitol (1,5-AG)d,e	Diabetes management—when HbA1c is ≥6.5% and ≤8.0%
10379	Hemoglobin A1c With eAG With Reflex to 1,5-Anhydroglucitol (1,5-AG)d,e
Other monitoring tests
NA	Blood Glucose Monitoring (BGM)	Diabetes management—determine real-time response to insulin therapy on a daily basis.
NA	Continuous Glucose Monitoring
Monitoring diabetic complications
91713	Diabetes, Advancing Chronic Kidney Disease Management Panelb Includes electrolyte panel (34392) (includes sodium [836], potassium [733], chloride [330], carbon dioxide [310]), hemoglobin (510[X]), intact PTH and calcium (8837), phosphate (phosphorus [718]), total 25-hydroxyvitamin D by immunoassay (17306), serum creatinine (375) with eGFR (calculated); and albumin, random urine with creatinine (6517).	Diabetes management—monitor chronic kidney disease in patients with diabetic nephropathy
92062	Diabetes and ASCVD Risk Panel With Scoresb Includes glucose (483); HbA1c (496); total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896) with reflex to direct LDL (8293); cholesterol/HDL ratio (calculated); non-HDL (calculated); 8-year risk of developing diabetes (calculated); and 10-year and lifetime atherosclerotic cardiovascular risk scores (calculated).	Diagnosis of prediabetes Assess risk for developing type 2 diabetes mellitus and cardiovascular disease Identify patients suitable for lifestyle interventions and/or pharmacotherapy
94588	Cystatin C With Glomerular Filtration Rate, Estimated (eGFR)	Diabetes management—monitor chronic kidney disease in patients with diabetic nephropathy in patients for whom creatinine-based results may lead to an incorrect diagnosisf
10350	Enhanced Liver Fibrosis (ELF) Score	Assess likelihood that nonalcoholic steatohepatitis (NASH) will progress to cirrhosis and liver-related clinical events. Used for patients with indeterminant or high FIB-4 results.6
30555	Liver Fibrosis, Fibrosis-4 (FIB-4) Index Panel Includes ALT (823), AST (822), platelet count (723), and FIB-4 index (calculated).	Screen for fibrosis in individuals with prediabetes and CVD risk factors, type 2 diabetes, or type 1 diabetes (only if additional risk factors such as obesity, hepatic steatosis, or elevated liver aminotransferases are present). Preferred option by the ADA.6
39165	Kidney Profileb Includes albumin, random urine with creatinine (6517) and serum creatinine (375) with calculated eGFR.	Diabetes management—monitor onset and progression of kidney disease
7600(X)	Lipid Panel, Standardb Includes total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896); cholesterol/HDL ratio (calculated); non-HDL (calculated).	Diabetes management—monitor dyslipidemia and thus risk of heart disease
91979	NAFLD Fibrosis Scoreb Includes albumin (223), ALT (823), AST (822), glucose (483), personal factors, platelet count (723), and calculated components (BMI and fibrosis score).	Diabetes management—assess likelihood of significant liver fibrosis related to NAFLD

1,5-AG, 1,5-anhydroglucitol; ACOG, American College of Obstetricians and Gynecologists; ADA, American Diabetes Association; ALT, alanine aminotransferase; ASCVD, atherosclerotic cardiovascular disease; AST, aspartate aminotransferase; BGM, blood glucose monitoring; eAG, estimated average glucose; eGFR, estimated glomerular filtration rate; FPG, fasting plasma glucose; HbA1c, hemoglobin A1c; HDL, high-density lipoprotein; LDL, low-density lipoprotein; NA, not available through Quest Diagnostics; NAFLD, nonalcoholic fatty liver disease; OGTT, oral glucose tolerance test; PPG, postprandial plasma glucose; PTH, parathyroid hormone.
a	The analytical performance characteristics of this assay have been determined by Quest Diagnostics. The modifications have not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
b	Panel components may be ordered separately.
c	The risk score, expressed as a percentage, is calculated with an algorithm that incorporates levels of HbA1c, FPG, high-density lipoprotein (HDL) cholesterol, and triglycerides, as well as patient age and sex.2
d	Determined using a National Glycohemoglobin Standardization Program (NGSP)-certified HbA1c method that is corrected for common hemoglobin variants.1
e	Reflex tests are performed at additional charge and are associated with an additional CPT code.
f	Pregnant women, patients with acute illness, patients with serious comorbid conditions, people with extremes of muscle mass (eg, bodybuilders, patients with amputation, paraplegia, muscle-wasting disease, or a neuromuscular disorder), patients suffering from malnutrition, those with a vegetarian or low-meat diet, and those taking creatine dietary supplements.

Table 2. Diagnostic Significance of Glucose and Hemoglobin A1c Concentrations

Individuals suitable for testing	Marker	Clinically significant level	Interpretation
Nonpregnant individuals with diabetes risk factors or age ≥35 years1	FPG	≥126 mg/dL	Diabetes mellitusa,b,c
	2-h OGTT (75 g)	≥200 mg/dL
	HbA1c leveld	≥6.5%
	FPG	100 to 125 mg/dL	Prediabetesb
	2-h OGTT (75 g)	140 to 199 mg/dL
	HbA1c leveld	5.7% to 6.4%
All individuals planning pregnancy1	FPG	100 to 125 mg/dL	Increased risk for diabetes and adverse pregnancy and neonatal outcomes
	HbA1c leveld	5.9% to 6.4%
All pregnant individuals (24-28 weeks of gestation)1	2-h OGTT (75 g)
All pregnant individuals (24-28 weeks of gestation)1	Fasting	≥92 mg/dL	Gestational diabetese,f,g
	1 h	≥180 mg/dL
	2 h	≥153 mg/dL

ACOG, American College of Obstetricians and Gynecologists; ADA, American Diabetes Association; FPG, fasting plasma glucose; HbA1c, hemoglobin A1c; OGTT, oral glucose tolerance test.
a	Unless unequivocal hyperglycemia is present, diagnosis requires 2 clinically significant test results (either the same test using a new blood sample or 2 different tests). If 2 different tests (eg, HbA1c and FPG) are performed and 1 gives clinically significant results and the other does not, the test with clinically significant results should be repeated. If the repeat test result is also clinically significant, diabetes is diagnosed.
b	If tests are normal, repeat testing at 3-year intervals, sooner if change in symptoms or risk (eg, weight gain).
c	If tests are close to diagnostic thresholds, repeat testing in 3 to 6 months.
d	HbA1c testing is contraindicated in patients with abnormal red cell turnover.
e	Only 1 of the 3 time points needs to be elevated to make the diagnosis.
f	Repeat 2-h OGTT 12 to 14 weeks postpartum and interpret results per nonpregnant individuals.
g	The 1-step strategy is listed; the alternative 2-step strategy involves a 1-hour OGTT (50 g) screen in nonfasting individuals; if the indicated cutoff is met (ie, ≥135 mg/dL or ≥140 mg/dL), a 3-h OGTT (100 g) is performed with collection of 4 specimens (fasting, 1-, 2-, and 3-hour). According to the ADA, gestational diabetes is diagnosed if 2 specimens meet or exceed the following glucose levels: fasting, 95 mg/dL; 1-hour, 180 mg/dL; 2-hour, 155 mg/dL; and 3-hour, 140 mg/dL (ACOG requires only 1 elevated specimen for diagnosis of gestational diabetes).1

Table 3. Recommended Testing Frequency and Goals for Diabetes Management

Marker	Target levels in patients with diabetesa	Testing frequencyb
Blood glucose
BGM and CGM	Patients using multiple insulin injections or an insulin pump: 80 to 130 mg/dL (fasting or before meals)7 <180 mg/dL (1-2 hours after start of meal)7 ≤95 mg/dL (gestational diabetes; fasting or before meals)10 ≤140 mg/dL (gestational diabetes; 1 hour after meal)10 ≤120 mg/dL (gestational diabetes; 2 hours after meal)	Varies for individuals BGM usually 6-10 times daily including12 Fasting Prior to meals and snacks and after meals When they suspect low blood 10glucose or after treating low blood glucose until levels are normal Prior to exercise or driving Bedtime Real-time CGM devices should be used as close to daily as possible for maximum benefit.12 Intermittently scanned CGM devices should be scanned every 8 hours to reveal glucose levels.12 CGM devices may be worn for 7-14 days (data may be blinded or visible to the wearer).12
HbA1c test
HbA1c level	Nonpregnant adults: <7.0% without significant hypoglycemia7 Patients with a history of severe hypoglycemia, extensive comorbidities, or a long-standing diagnosis in whom lower targets are difficult to achieve: <8%7	Initial visit Follow-up Every 6 months for patients with stable glycemia who meet glycemic goals Every 3 months and as needed for patients who have changed therapy and/or are not meeting glycemic goals More frequently for patients with unstable glycemia and those undergoing intensive management (eg, pregnant women with type 1 diabetes)

eAGc	<154 mg/dL (8.6 mmol/L)7	Same as for HbA1c level
1,5-AG
1,5-AG level	≥8.0 μg/mL11	At time of HbA1c test if HbA1c levels are moderately or well-controlled to detect PPG excursions. As clinically indicated to monitor short- to intermediate-term glucose control.

1,5-AG, 1,5-anhydroglucitol; BGM, blood glucose monitoring; CGM, continuous glucose monitoring; eAG, estimated average glucose; HbA1c, hemoglobin A1c; PPG, postprandial plasma glucose.
a	Achieving glucose, HbA1c, eAG, and 1,5-AG goals should be balanced against risk of inducing hypoglycemia
b	Suggested testing frequency is generalized for routine monitoring and may vary depending on clinical condition and treatment regimen.
c	eAG values in mg/dL are calculated by converting HbA1c levels to eAG using the following formula4,5: eAG = HbA1c x 28.7 - 46.7. eAG values in mg/dL can be converted to mmol/L by dividing by 18.

Table 4. Recommended Testing Frequency and Goals for Monitoring Diabetic Complications

Marker	Target levels in patients with diabetes	Testing frequency when at targeta
Creatinine level and eGFR18	eGFR ≥60 mL/min/1.73 m2	Every year
Fasting lipid profile (LDL, HDL, TG)6,19	LDL: <70 mg/dL HDL: ≥40 mg/dL(men); ≥50 mg/dL(women) TG: <150 mg/dL	Initial visit and annually thereafter (adults not taking statins); as needed to monitor adherence and efficacy of introducing statin therapy or for patients with CVD
FIB-46	Score: <F2	Repeat every 2 to 3 years
Urine albumin/creatinine ratio18	<30 μg/mg creatinine (normal)	Once a year in patients with type 1 diabetes who have had diabetes for at least 5 years; once a year in all patients with type 2 diabetes

CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; TG, triglycerides.
a	Suggested testing frequency is generalized for routine monitoring and may vary depending on clinical condition and treatment regimen.

References

American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S19-S40. doi:10.2337/dc23-S002
Leong A, Daya N, Porneala B, et al. Prediction of type 2 diabetes by hemoglobin A1c in two community-based cohorts. Diabetes Care. 2018;41(1):60-68. doi:10.2337/dc17-0607
Understanding A1C. A1C and eAG. American Diabetes Association. Accessed January 19, 2023. https://www.diabetes.org/diabetes/a1c-test-meaning/a1c-and-eag
eAG/A1C conversion calculator. American Diabetes Association. Accessed January 19, 2013. http://professional.diabetes.org/diapro/glucose_calc.
Nathan DM, Kuenen J, Borg R, et al. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31(8):1473-1478. doi:10.2337/dc08-0545
American Diabetes Association Professional Practice Committee. 4. Comprehensive medical evaluation and assessment of comorbidities: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S49-S67. doi:10.2337/dc23-S004
American Diabetes Association Professional Practice Committee. 6. Gycemic targets: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S97-S119. doi:10.2337/dc23-S006
American Diabetes Association. Standards of medical care in diabetes—2023 abridged for primary care providers. Clin Diabetes. 2023;41(1):4-31. doi:10.2337/cd23-as01
American Diabetes Association. Erratum: Standards of medical care in diabetes—2023 abridged for primary care providers. Clin Diabetes. 2023;cd23er02a doi:10.2337/cd23-er02a
American Diabetes Association Professional Practice Committee. 15. Management of diabetes in pregnancy: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S254-S266. doi:10.2337/dc23-S015
Dungan KM, Buse JB, Largay J, et al. 1,5-Anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes. Diabetes Care. 2006;29(6):1214-1219. doi:10.2337/dc06-1910
American Diabetes Association Professional Practice Committee. 7. Diabetes technology: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S111-S127. doi:10.2337/dc23-S007
Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-412. doi:10.1136/bmj.321.7258.405
Wright LA, Hirsch IB. Metrics beyond hemoglobin A1C in diabetes management: time in range, hypoglycemia, and other parameters. Diabetes Technol Ther. 2017;19(S2):S16-S26. doi:10.1089/dia.2017.0029
Peabody J, Paculdo D, Acelajado MC, et al. Finding the clinical utility of 1,5-anhydroglucitol among primary care practitioners. J Clin Transl Endocrinol. 2020;20:100224. doi:10.1016/j.jcte.2020.100224
Selvin E, Wang D, McEvoy JW, et al. Response of 1,5-anhydroglucitol level to intensive glucose- and blood-pressure lowering interventions, and its associations with clinical outcomes in the ADVANCE trial. Diabetes Obes Metab. 2019;21(8):2017-2023. doi:10.1111/dom.13755
JARDIANCE® (empagliflozin tablets). Package insert. Boehringer Ingelheim International GmbH. Updated February, 2022. Accessed February 21, 2023. https://content.boehringer-ingelheim.com/DAM/7d9c411c-ec33-4f82-886f-af1e011f35bb/jardiance-us-pi.pdf
American Diabetes Association Professional Practice Committee. 11. Chronic kidney disease and risk management: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S191-S202. doi:10.2337/dc23-S011
American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S158-S190. doi:10.2337/dc23-S010

Content reviewed 03/2023

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This test guide discusses the use and interpretation of laboratory tests for diagnosing diabetes and monitoring glycemic control.

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Laboratory Testing for Diabetes Diagnosis and Management

This Test Guide discusses the use of laboratory tests for diagnosing diabetes mellitus, monitoring glycemic control in individuals with diabetes, and monitoring diabetic complications.

Diagnosis

Management

Table 1. Tests Used in Diabetes Diagnosis and Management

Test code	Test name (panel components)	Primary clinical use and differentiating factors
10378	1,5-Anhydroglucitol (1,5-AG), Intermediate Glycemic Controla	Diabetes management—measure glycemic control over the intermediate term (1 to 2 weeks)
92027	Diabetes Risk Panel With Scoreb Includes glucose (483); HbA1c (496); total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896) with reflex to direct LDL (8293); cholesterol/HDL ratio (calculated); non-HDL (calculated); and 8-year risk of developing diabetes (calculated).	Diagnosis of prediabetes Calculate 8-year riskc for developing type 2 diabetes mellitus2
91920	Diabetes Risk Panel Without Scoreb Includes glucose (483); HbA1c (496); total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896) with reflex to direct LDL (8293); cholesterol/HDL ratio (calculated); and non-HDL (calculated).	Diagnosis of prediabetes Assess risk for developing type 2 diabetes mellitus Identifies patients suitable for lifestyle interventions and/or pharmacotherapy
91712	Diabetes, Newly Diagnosed and Monitoring Panelb Includes glucose (483); HbA1c (496); hepatic function panel (total protein [754], albumin [223], globulin [calculated], albumin/globulin ratio [calculated], total [287], direct [285], and indirect [calculated] bilirubin, alkaline phosphatase [234], AST [822], and ALT [823]); lipid panel (total [334], HDL [608], and LDL [calculated] cholesterol; triglycerides [896] with reflex to direct LDL [8293]; cholesterol/HDL ratio [calculated]; and non-HDL [calculated]); serum creatinine (375) with eGFR (calculated); and albumin, random urine with creatinine (6517) (includes albumin and creatinine, random urine 8459[X] and albumin/creatinine ratio [calculated]).	Diabetes management—establish baseline measurements for patients with a recent diagnosis of diabetes mellitus Monitor patients with diabetes mellitus
8340	Fructosamine	Diabetes management—measure glycemic control over the intermediate term (2 to 3 weeks)
8477	Glucose, Gestational Screen (50g), 135 Cutoff	Screen (without prior fasting) for gestational diabetes using a 1-hour (post 50-g glucose loading) specimen (ADA- and ACOG-supported 1st step of 2-step evaluation); a cutoff of 135 mg/dL (test code 8477) or 140 mg/dL (test code 19833) indicates that the 2nd step (test code 6745) is necessary
19833	Glucose, Gestational Screen (50g), 140 Cutoff
484	Glucose, Plasma	Diagnosis based on FPG
18927	Glucose Tolerance Test, Gestational, 3 Specimens (75g)	Diagnosis of gestational diabetes (ADA-supported 1-step evaluation)
35181	Glucose Tolerance Test, 2 Specimens (75g)	Diagnosis based on fasting and 2-hour (post 75-g glucose loading) specimens (2-hour OGTT)
23475	Glucose Tolerance Test, 3 Specimens (75g)	Diagnosis based on fasting, 1-, and 2-hour (post 75-g glucose loading) specimens
6745	Glucose Tolerance Test, Gestational, 4 Specimens (100g)	Diagnosis of gestational diabetes based on fasting, 1-, 2-, and 3-hour (post 100-g glucose loading) specimens (ADA- and ACOG-supported 2nd step of 2-step evaluation)
496	Hemoglobin A1cd	Diagnosis and management—determine long-term average blood glucose, expressed as a percentage.
16802	Hemoglobin A1c With eAGd	Diabetes management—determine long-term average blood glucose; expressed in percent HbA1c and calculated estimated average glucose (eAG) in conventional blood glucose units for more convenient comparison to BGM values.1,3-5
10380	Hemoglobin A1c With Reflex to 1,5-Anhydroglucitol (1,5-AG)d,e	Diabetes management—when HbA1c is ≥6.5% and ≤8.0%
10379	Hemoglobin A1c With eAG With Reflex to 1,5-Anhydroglucitol (1,5-AG)d,e
Other monitoring tests
NA	Blood Glucose Monitoring (BGM)	Diabetes management—determine real-time response to insulin therapy on a daily basis.
NA	Continuous Glucose Monitoring
Monitoring diabetic complications
91713	Diabetes, Advancing Chronic Kidney Disease Management Panelb Includes electrolyte panel (34392) (includes sodium [836], potassium [733], chloride [330], carbon dioxide [310]), hemoglobin (510[X]), intact PTH and calcium (8837), phosphate (phosphorus [718]), total 25-hydroxyvitamin D by immunoassay (17306), serum creatinine (375) with eGFR (calculated); and albumin, random urine with creatinine (6517).	Diabetes management—monitor chronic kidney disease in patients with diabetic nephropathy
92062	Diabetes and ASCVD Risk Panel With Scoresb Includes glucose (483); HbA1c (496); total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896) with reflex to direct LDL (8293); cholesterol/HDL ratio (calculated); non-HDL (calculated); 8-year risk of developing diabetes (calculated); and 10-year and lifetime atherosclerotic cardiovascular risk scores (calculated).	Diagnosis of prediabetes Assess risk for developing type 2 diabetes mellitus and cardiovascular disease Identify patients suitable for lifestyle interventions and/or pharmacotherapy
94588	Cystatin C With Glomerular Filtration Rate, Estimated (eGFR)	Diabetes management—monitor chronic kidney disease in patients with diabetic nephropathy in patients for whom creatinine-based results may lead to an incorrect diagnosisf
10350	Enhanced Liver Fibrosis (ELF) Score	Assess likelihood that nonalcoholic steatohepatitis (NASH) will progress to cirrhosis and liver-related clinical events. Used for patients with indeterminant or high FIB-4 results.6
30555	Liver Fibrosis, Fibrosis-4 (FIB-4) Index Panel Includes ALT (823), AST (822), platelet count (723), and FIB-4 index (calculated).	Screen for fibrosis in individuals with prediabetes and CVD risk factors, type 2 diabetes, or type 1 diabetes (only if additional risk factors such as obesity, hepatic steatosis, or elevated liver aminotransferases are present). Preferred option by the ADA.6
39165	Kidney Profileb Includes albumin, random urine with creatinine (6517) and serum creatinine (375) with calculated eGFR.	Diabetes management—monitor onset and progression of kidney disease
7600(X)	Lipid Panel, Standardb Includes total (334), HDL (608), and LDL (calculated) cholesterol; triglycerides (896); cholesterol/HDL ratio (calculated); non-HDL (calculated).	Diabetes management—monitor dyslipidemia and thus risk of heart disease
91979	NAFLD Fibrosis Scoreb Includes albumin (223), ALT (823), AST (822), glucose (483), personal factors, platelet count (723), and calculated components (BMI and fibrosis score).	Diabetes management—assess likelihood of significant liver fibrosis related to NAFLD

1,5-AG, 1,5-anhydroglucitol; ACOG, American College of Obstetricians and Gynecologists; ADA, American Diabetes Association; ALT, alanine aminotransferase; ASCVD, atherosclerotic cardiovascular disease; AST, aspartate aminotransferase; BGM, blood glucose monitoring; eAG, estimated average glucose; eGFR, estimated glomerular filtration rate; FPG, fasting plasma glucose; HbA1c, hemoglobin A1c; HDL, high-density lipoprotein; LDL, low-density lipoprotein; NA, not available through Quest Diagnostics; NAFLD, nonalcoholic fatty liver disease; OGTT, oral glucose tolerance test; PPG, postprandial plasma glucose; PTH, parathyroid hormone.
a	The analytical performance characteristics of this assay have been determined by Quest Diagnostics. The modifications have not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
b	Panel components may be ordered separately.
c	The risk score, expressed as a percentage, is calculated with an algorithm that incorporates levels of HbA1c, FPG, high-density lipoprotein (HDL) cholesterol, and triglycerides, as well as patient age and sex.2
d	Determined using a National Glycohemoglobin Standardization Program (NGSP)-certified HbA1c method that is corrected for common hemoglobin variants.1
e	Reflex tests are performed at additional charge and are associated with an additional CPT code.
f	Pregnant women, patients with acute illness, patients with serious comorbid conditions, people with extremes of muscle mass (eg, bodybuilders, patients with amputation, paraplegia, muscle-wasting disease, or a neuromuscular disorder), patients suffering from malnutrition, those with a vegetarian or low-meat diet, and those taking creatine dietary supplements.

Table 2. Diagnostic Significance of Glucose and Hemoglobin A1c Concentrations

Individuals suitable for testing	Marker	Clinically significant level	Interpretation
Nonpregnant individuals with diabetes risk factors or age ≥35 years1	FPG	≥126 mg/dL	Diabetes mellitusa,b,c
	2-h OGTT (75 g)	≥200 mg/dL
	HbA1c leveld	≥6.5%
	FPG	100 to 125 mg/dL	Prediabetesb
	2-h OGTT (75 g)	140 to 199 mg/dL
	HbA1c leveld	5.7% to 6.4%
All individuals planning pregnancy1	FPG	100 to 125 mg/dL	Increased risk for diabetes and adverse pregnancy and neonatal outcomes
	HbA1c leveld	5.9% to 6.4%
All pregnant individuals (24-28 weeks of gestation)1	2-h OGTT (75 g)
All pregnant individuals (24-28 weeks of gestation)1	Fasting	≥92 mg/dL	Gestational diabetese,f,g
	1 h	≥180 mg/dL
	2 h	≥153 mg/dL

ACOG, American College of Obstetricians and Gynecologists; ADA, American Diabetes Association; FPG, fasting plasma glucose; HbA1c, hemoglobin A1c; OGTT, oral glucose tolerance test.
a	Unless unequivocal hyperglycemia is present, diagnosis requires 2 clinically significant test results (either the same test using a new blood sample or 2 different tests). If 2 different tests (eg, HbA1c and FPG) are performed and 1 gives clinically significant results and the other does not, the test with clinically significant results should be repeated. If the repeat test result is also clinically significant, diabetes is diagnosed.
b	If tests are normal, repeat testing at 3-year intervals, sooner if change in symptoms or risk (eg, weight gain).
c	If tests are close to diagnostic thresholds, repeat testing in 3 to 6 months.
d	HbA1c testing is contraindicated in patients with abnormal red cell turnover.
e	Only 1 of the 3 time points needs to be elevated to make the diagnosis.
f	Repeat 2-h OGTT 12 to 14 weeks postpartum and interpret results per nonpregnant individuals.
g	The 1-step strategy is listed; the alternative 2-step strategy involves a 1-hour OGTT (50 g) screen in nonfasting individuals; if the indicated cutoff is met (ie, ≥135 mg/dL or ≥140 mg/dL), a 3-h OGTT (100 g) is performed with collection of 4 specimens (fasting, 1-, 2-, and 3-hour). According to the ADA, gestational diabetes is diagnosed if 2 specimens meet or exceed the following glucose levels: fasting, 95 mg/dL; 1-hour, 180 mg/dL; 2-hour, 155 mg/dL; and 3-hour, 140 mg/dL (ACOG requires only 1 elevated specimen for diagnosis of gestational diabetes).1

Table 3. Recommended Testing Frequency and Goals for Diabetes Management

Marker	Target levels in patients with diabetesa	Testing frequencyb
Blood glucose
BGM and CGM	Patients using multiple insulin injections or an insulin pump: 80 to 130 mg/dL (fasting or before meals)7 <180 mg/dL (1-2 hours after start of meal)7 ≤95 mg/dL (gestational diabetes; fasting or before meals)10 ≤140 mg/dL (gestational diabetes; 1 hour after meal)10 ≤120 mg/dL (gestational diabetes; 2 hours after meal)	Varies for individuals BGM usually 6-10 times daily including12 Fasting Prior to meals and snacks and after meals When they suspect low blood 10glucose or after treating low blood glucose until levels are normal Prior to exercise or driving Bedtime Real-time CGM devices should be used as close to daily as possible for maximum benefit.12 Intermittently scanned CGM devices should be scanned every 8 hours to reveal glucose levels.12 CGM devices may be worn for 7-14 days (data may be blinded or visible to the wearer).12
HbA1c test
HbA1c level	Nonpregnant adults: <7.0% without significant hypoglycemia7 Patients with a history of severe hypoglycemia, extensive comorbidities, or a long-standing diagnosis in whom lower targets are difficult to achieve: <8%7	Initial visit Follow-up Every 6 months for patients with stable glycemia who meet glycemic goals Every 3 months and as needed for patients who have changed therapy and/or are not meeting glycemic goals More frequently for patients with unstable glycemia and those undergoing intensive management (eg, pregnant women with type 1 diabetes)

eAGc	<154 mg/dL (8.6 mmol/L)7	Same as for HbA1c level
1,5-AG
1,5-AG level	≥8.0 μg/mL11	At time of HbA1c test if HbA1c levels are moderately or well-controlled to detect PPG excursions. As clinically indicated to monitor short- to intermediate-term glucose control.

1,5-AG, 1,5-anhydroglucitol; BGM, blood glucose monitoring; CGM, continuous glucose monitoring; eAG, estimated average glucose; HbA1c, hemoglobin A1c; PPG, postprandial plasma glucose.
a	Achieving glucose, HbA1c, eAG, and 1,5-AG goals should be balanced against risk of inducing hypoglycemia
b	Suggested testing frequency is generalized for routine monitoring and may vary depending on clinical condition and treatment regimen.
c	eAG values in mg/dL are calculated by converting HbA1c levels to eAG using the following formula4,5: eAG = HbA1c x 28.7 - 46.7. eAG values in mg/dL can be converted to mmol/L by dividing by 18.

Table 4. Recommended Testing Frequency and Goals for Monitoring Diabetic Complications

Marker	Target levels in patients with diabetes	Testing frequency when at targeta
Creatinine level and eGFR18	eGFR ≥60 mL/min/1.73 m2	Every year
Fasting lipid profile (LDL, HDL, TG)6,19	LDL: <70 mg/dL HDL: ≥40 mg/dL(men); ≥50 mg/dL(women) TG: <150 mg/dL	Initial visit and annually thereafter (adults not taking statins); as needed to monitor adherence and efficacy of introducing statin therapy or for patients with CVD
FIB-46	Score: <F2	Repeat every 2 to 3 years
Urine albumin/creatinine ratio18	<30 μg/mg creatinine (normal)	Once a year in patients with type 1 diabetes who have had diabetes for at least 5 years; once a year in all patients with type 2 diabetes

CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; TG, triglycerides.
a	Suggested testing frequency is generalized for routine monitoring and may vary depending on clinical condition and treatment regimen.

References

American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S19-S40. doi:10.2337/dc23-S002
Leong A, Daya N, Porneala B, et al. Prediction of type 2 diabetes by hemoglobin A1c in two community-based cohorts. Diabetes Care. 2018;41(1):60-68. doi:10.2337/dc17-0607
Understanding A1C. A1C and eAG. American Diabetes Association. Accessed January 19, 2023. https://www.diabetes.org/diabetes/a1c-test-meaning/a1c-and-eag
eAG/A1C conversion calculator. American Diabetes Association. Accessed January 19, 2013. http://professional.diabetes.org/diapro/glucose_calc.
Nathan DM, Kuenen J, Borg R, et al. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31(8):1473-1478. doi:10.2337/dc08-0545
American Diabetes Association Professional Practice Committee. 4. Comprehensive medical evaluation and assessment of comorbidities: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S49-S67. doi:10.2337/dc23-S004
American Diabetes Association Professional Practice Committee. 6. Gycemic targets: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S97-S119. doi:10.2337/dc23-S006
American Diabetes Association. Standards of medical care in diabetes—2023 abridged for primary care providers. Clin Diabetes. 2023;41(1):4-31. doi:10.2337/cd23-as01
American Diabetes Association. Erratum: Standards of medical care in diabetes—2023 abridged for primary care providers. Clin Diabetes. 2023;cd23er02a doi:10.2337/cd23-er02a
American Diabetes Association Professional Practice Committee. 15. Management of diabetes in pregnancy: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S254-S266. doi:10.2337/dc23-S015
Dungan KM, Buse JB, Largay J, et al. 1,5-Anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes. Diabetes Care. 2006;29(6):1214-1219. doi:10.2337/dc06-1910
American Diabetes Association Professional Practice Committee. 7. Diabetes technology: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S111-S127. doi:10.2337/dc23-S007
Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-412. doi:10.1136/bmj.321.7258.405
Wright LA, Hirsch IB. Metrics beyond hemoglobin A1C in diabetes management: time in range, hypoglycemia, and other parameters. Diabetes Technol Ther. 2017;19(S2):S16-S26. doi:10.1089/dia.2017.0029
Peabody J, Paculdo D, Acelajado MC, et al. Finding the clinical utility of 1,5-anhydroglucitol among primary care practitioners. J Clin Transl Endocrinol. 2020;20:100224. doi:10.1016/j.jcte.2020.100224
Selvin E, Wang D, McEvoy JW, et al. Response of 1,5-anhydroglucitol level to intensive glucose- and blood-pressure lowering interventions, and its associations with clinical outcomes in the ADVANCE trial. Diabetes Obes Metab. 2019;21(8):2017-2023. doi:10.1111/dom.13755
JARDIANCE® (empagliflozin tablets). Package insert. Boehringer Ingelheim International GmbH. Updated February, 2022. Accessed February 21, 2023. https://content.boehringer-ingelheim.com/DAM/7d9c411c-ec33-4f82-886f-af1e011f35bb/jardiance-us-pi.pdf
American Diabetes Association Professional Practice Committee. 11. Chronic kidney disease and risk management: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S191-S202. doi:10.2337/dc23-S011
American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: standards of medical care in diabetes—2023. Diabetes Care. 2023;46(suppl 1):S158-S190. doi:10.2337/dc23-S010

Content reviewed 03/2023

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Test Code 19833

Glucose, Gestational Screen (50g), 140 Cutoff

A value of 140 mg/dL or greater indicates the need for a full diagnostic, gestational glucose tolerance performed in the fasting state to determine if the patient has gestational diabetes.

Test Code 10350

Enhanced Liver Fibrosis (ELF) Score

The Enhanced Liver Fibrosis (ELF) score predicts progression to cirrhosis and liver-related events in patients with advanced fibrosis due to NASH.

The ELF score is not for use in the diagnosis of NASH, the staging of fibrosis, the serial monitoring of disease progression, or the monitoring of effects of therapeutic products.

The ELF score is derived from an algorithm that combines measurements of PIIINP, TIMP-1, and HA. PIIINP is a marker of early fibrogenesis and i

Test Code 10378

1,5-Anhydroglucitol (1,5-AG), Intermediate Glycemic Control

Diazyme 1,5-anhydroglucitol (1,5-AG) Assay is an enzymatic method intended for the quantitative determination of 1,5-anhydroglucitol (1,5-AG) in serum or plasma. The 1,5-AG Assay is for the intermediate term (preceding 1-2 weeks) monitoring of glycemic control in people with diabetes.

Test Code 10379

Hemoglobin A1c with eAG with Reflex to 1,5-Anhydroglucitol (1,5-AG)

To assist with control of blood glucose levels, the American Diabetes Association (ADA) has recommended glycated hemoglobin testing (HbA1c) twice a year for patients with stable glycemia, and quarterly for patients with poor glucose control. Interpretative ranges are based on ADA guidelines.

Test Code 94588

Cystatin C with Glomerular Filtration Rate, Estimated (eGFR)

Cystatin C is a non-glycosylated, low molecular weight (13,250 kD) cysteine proteinase inhibitor that is produced by all nucleated cells and found in body fluids, including serum. Since it is formed at a constant rate and freely filtered by the kidneys, its serum concentration is inversely correlated with the glomerular filtration rate (GFR); that is,high values indicate low GFRs while lower values indicate higher GFRs, similar to creatinine. The renal handling of cystatin C differs from creatin

Test Code 375

Creatinine

Serum creatinine is useful in the evaluation of kidney function and in monitoring renal dialysis. A serum creatinine result within the reference range does not rule out renal function impairment: serum creatinine is not sensitive to early renal damage since it varies with age, gender and ethnic background. The impact of these variables can be reduced by an estimation of the glomerular filtration rate using an equation that includes serum creatinine, age and gender.

Test Code 30555

Liver Fibrosis, Fibrosis-4 (FIB-4) Index Panel

The FIB-4 index is a simple non-invasive approach using selected laboratory measures (AST, ALT, platelet count) in combination with patient age to assess if an individual is at higher risk for advanced liver fibrosis (F3-F4).

Test Code 6517

Albumin, Random Urine with Creatinine

This test is used to detect albuminuria by measuring albumin and creatine concentrations in a random (spot) urine sample and calculating the albumin-creatinine ratio (ACR). This test is useful for assessing kidney damage, especially at an early stage, and informing management and prognosis of chronic kidney disease (CKD) [1].

Albuminuria, as a marker of kidney damage, provides a more specific and sensitive measurement of glomerular permeability than does proteinuria. An ACR measured from

Test Code 6745

Glucose Tolerance Test, Gestational, 4 Specimens (100g)

Plasma glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders.

Test Code 7600

Lipid Panel, Standard

The Lipid Panel, Standard measures serum cholesterol and triglyceride (TG) levels; it includes evaluation of the cholesterol/HDL-C ratio (calculated), HDL-C, LDL-C (calculated), non-HDL-C (calculated), total cholesterol, and TG. Comprehensive lipid assessment aids in the evaluation of cardiovascular risk and the likelihood of suffering an ischemic event. It is also useful for the prevention and management of atherosclerotic disease, as well as the diagnosis of metabolic syndrome [1].

Test Code 91712

Diabetes, Newly Diagnosed and Monitoring Panel

Test Code 484

Glucose, Plasma

Plasma glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders including diabetes mellitus, idiopathic hypoglycemia, and pancreatic islet cell neoplasm.

Test Code 496

Hemoglobin A1c

Test Code 8477

Glucose, Gestational Screen (50g), 135 Cutoff

A value of 135 mg/dL or greater indicates the need for a full diagnostic, gestational glucose tolerance performed in the fasting state to determine if the patient has gestational diabetes.

Test Code 8340

Fructosamine

The fructosamine assay is useful in monitoring the degree of glycemia over short-to-intermediate time frames (1-3 weeks). A fructosamine concentration greater than the established normal range is an indication of prolonged hyperglycemia of 1-3 weeks or longer. The higher the fructosamine value, the poorer the degree of glycemia control.

Test Code 91979

NAFLD Fibrosis Score

The NAFLD fibrosis score is a simple noninvasive approach to identify patients that may have significant liver fibrosis and who therefore might benefit from additional studies such as elastography or liver biopsy. Non-alcoholic fatty liver disease (NAFLD) affects approximately 30% of adults in developed countries. It is associated with obesity, diabetes, and dyslipidemia and is considered the liver manifestation of the metabolic syndrome. This disease is often asymptomatic. In some individuals,

Test Code 16802

Hemoglobin A1c with eAG

Test Code 39165

Kidney Profile

This Profile combines two common tests-estimated glomerular filtration rate and urine albumin-creatinine ratio to support early detection of Chronic Kidney Disease (CKD). This profile supports the National Kidney Foundation initiative to drive adoption of the profile to facilitate appropriate ordering of the elements of the profile to address early detection of (CKD). A NHANES (CDC) study showed that only 8% of people with an eGFR <60 mL/min/1.73 m2 knew they had CKD. For those with the same

Test Code 23475

Glucose Tolerance Test, 3 Specimens (75g)

This test is used for the routine diagnosis of diabetes in children and the non-pregnant adult. For pregnant females see test "Glucose Tolerance Test, Gestational, 4 Specimens (100 g)". For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose. Immediately after, a fasting specimen is obtained. For children, the glucose load is 1.75 g/Kg of body weight, up to 75. The diagnosis of diabetes is made if the fasting gl

Test Code 91920

Diabetes Risk Panel without Score

Test Code 10380

Hemoglobin A1c with Reflex to 1,5-Anhydroglucitol (1,5-AG)

Test Code 91713

Diabetes, Advancing Chronic Kidney Disease Management Panel

This panel is designed for individuals diagnosed as having diabetes mellitus whose kidney disease has advanced to Stage 3/4 impairment. The panel affords the opportunity to assess electrolytes, phosphorus, serum creatinine/eGFR, hemoglobin, microalbumin, parathyroid hormone, calcium, and vitamin D.
The grouping of these tests, readily identifiable as elements that adhere to guideline recommendations, is intended to facilitate the ready adherence to professional society clinical practice

Test Code 18927

Glucose Tolerance Test, Gestational, 3 Specimens (75g)

Plasma glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders.

Test Code 35181

Glucose Tolerance Test, 2 Specimens (75g)

This test is used for the routine diagnosis of diabetes in children and the non-pregnant adult. For pregnant females see test "Glucose Tolerance Test, Gestational, 4 Specimens (100 g)". For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose, immediately after, a fasting specimen is obtained. For children, the glucose load is 1.75 g/Kg of ideal body weight, up to 75 g glucose. The diagnosis of diabetes is made if the fasting glucose is Ͱ

Test Code 92027

Diabetes Risk Panel with Score

Test Code 92062

Diabetes and ASCVD Risk Panel with Scores

IG/Reference Manual

Test Guide List

This page is a complete list of Test Guides created by Quest Diagnostics.

Test Summary

Cardiometabolic Disease Assessment (CMDA) Panel

This panel is used to assess cardiometabolic dysfunction in the context of (1) early-stage measures of dyslipidemia and glycemic control, (2) common endocrine disorders, and (3) downstream adverse effects on end-organ dysfunction, including liver and kidney.

Topic Brief

Laboratory Diagnosis of Peripheral Neuropathy

This topic brief provides a brief review of the known causes of acquired peripheral neuropathies and the laboratory tests available for their evaluation and diagnosis.

Test Summary

Diabetes Type 1 Autoantibody Panel

This panel is used to diagnose type 1 diabetes (T1D) in symptomatic children and adults, differentially diagnose type 1 vs type 2 diabetes, assess risk for development of T1D in presymptomatic individuals, and determine teplizumab therapy or clinical trial eligibility.

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Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The tests listed by specialty and category are a select group of tests offered. For a complete list of Quest Diagnostics tests, please adjust the filter options chosen, or refer to our Directory of Services.

Laboratory Testing for Diabetes Diagnosis and Management

Laboratory Testing for Diabetes Diagnosis and Management

Test Guide

Test Guide

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