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[Clinical laboratory tests in diabetes mellitus].

The clinical diagnosis of diabetes is often prompted by symptoms such as increased thirst and urine volume, and weight loss. High levels of glucosuria are usually present. A single blood glucose estimation of diagnostic value indicated > or = 200 mg/dl at random, or > or = 140 mg/dl at fasting in specimens of venous plasma. Only if blood glucose values lie in the uncertain range (i.e., between the level that establish or exclude diabetes) need an oral glucose tolerance test (OGTT) be considered in order to establish the diagnosis status. Diagnostic interpretation of the 75 g OGTT responses is performed by the criteria of the expert committee of the Japan Diabetic Society. Glycated hemoglobin (HbA1c, HbA1) is widely used as a cumulative estimate of the mean blood glucose concentration over the preceding one approximately two months. Reference ranges of HbA1c are 4 approximately 6%. Labile glycohemoglobin often influences the estimate. Fructosamine and glycated albumin are also used as means of evaluating the degree of control. These data reveal the mean blood glucose concentration over the preceding 2 weeks. 1.5-Anhydroglucitol in blood is measured as a means of diagnosis and control evaluation of diabetes. Microalbuminuria is widely measured for early detection of diabetic nephropathy. Recently other microproteinuria such as urinary transferrin and IgG are assayed for the same purpose. There are highly significant correlations between microalbuminuria and urinary transferrin or IgG.