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Diabetes Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient’s names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Diabetes Testing:

Fasting Blood Sugar Test

What is the Fasting Blood Sugar Test?

Fasting Blood Sugar Test is a direct measurement of the blood glucose level. This test is used to evaluate diabetes in a patient.  

strong>Indications and Contraindications

The Fasting Blood Glucose evaluates the blood sugar levels of a patient. It is done to diagnose diabetes and to monitor diabetes.

To those who do not experience any symptoms of diabetes, testing is recommended if the following conditions are present/applicable:

• Obesity/Overweight (children, teens, adults)
• People over 45 years of age
• Family history of diabetes
• High blood pressure
• High triglycerides and cholesterol levels
• History of cardiovascular disease
• Pregnancy (at risk for gestational diabetes)
• Newborns that are over 9 pounds

How do you prepare for a Fasting Blood Glucose Test?

For a Fasting Blood Glucose Test, fasting is required for at least 8 hours, but not longer than 16 hours, prior to the blood test. The patient is only allowed to consume water. Insulin and hypoglycemic should not be taken.

How does it feel? How long will it take?

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You will feel nothing at all from the needle while your blood is being drawn, or you may feel a quick sting or pinch depending on your sensitivity to pain. Drawing a blood sample only lasts for a few minutes.

Expected effects after the test:

Normally, there are no major effects after the test. In most cases, patients may feel a little sore and slight bleeding may occur on the needle site. Bruising or swelling may occur.

Special instructions after the test:

After drawing blood, cover the needle site with a clean and dry bandage. If advised by the health care professional, apply pressure or warm compress on the area several times a day to minimize swelling and bruising. Follow instructions given by your physician on treatment for these kinds of side effects.

Because patients fast leading up to the test, it is recommended to bring a light snack to eat after the test in case you become hungry. You may return to your normal activities and regular diet after the test.

Results:

Normal Findings:

• Premature infant:- 20-60 mg/dl
• Neonate: 30-60 mg/dl
• Infant: 40-90 mg/dl
• Child < 2 years: 60-100 mg/d;
• Child > 2 years to adult: 70-105 mg/dl
• Elderly: increase in normal range after 50 years of age

                        Abnormal Findings:

• Adult male: < 50 and >400 mg/dl
• Adult female: <40 and  > 400 mg/dl
• Infant: <40 mg/dl
• Newborn: <30 and > 300 mg/dl

High blood sugar (hyperglycemia)

High blood sugar occurs when the sugar (glucose) level in your blood rises above normal. Eating too many calories, missing medicines (insulin or pills), or having an infection or illness, injury, surgery, or emotional stress can cause your blood sugar to rise. 

High blood sugar usually develops slowly over a period of hours to days. However, missing a dose of insulin can cause a rapid rise in blood sugar levels. Blood sugar levels just above the safe range may make you feel tired and thirsty. If your blood sugar level stays higher than normal for weeks, your body will adjust to that level, and you may not have as many symptoms of high blood sugar. 

Increased levels of glucose in the blood indicates the following conditions:

• Diabetes mellitus
• Cushing’s syndrome
• Chronic renal failure
• Glucagonoma
• Diuretic therapy
• Acromegaly

Low blood sugar (hypoglycemia)

Low blood sugar occurs when the sugar (glucose) level in your blood drops below what your body needs. Not eating enough food or skipping meals, take too much medicine (insulin or pills), exercising more than usual, or taking certain medicines that lower blood sugar can cause your blood sugar to drop rapidly. 

When your blood sugar level drops below 65 milligrams per deciliter (mg/dL), you will usually have symptoms of low blood sugar. This can develop quickly, in 10 to 15 minutes.

Decreased levels of blood glucose indicates the following conditions:

• Insulinoma
• Hypothyroidism
• Hypopituitarism
• Addison’s disease
• Insulin overdose
• Starvation

Notes:

Hyperglycemia

• Test your blood sugar often, especially if you are sick or are not following your normal routine. You can see when your blood sugar is above the safe range, even if you don't have symptoms of high blood sugar such as increased thirst, increased urination, and fatigue. Then you can treat it early, preventing an emergency.
• Notify your health professional if you have frequent high blood sugar levels or if your blood sugar level is consistently staying above the safe range. Your medicine may need to be adjusted or changed.
• Drink extra water or non-caffeinated, non-sugared drinks so you will not be dehydrated. If your blood sugar continues to rise, your kidneys will increase the amount of urine produced, and you can become dehydrated.
• Complications of high blood sugar can cause serious problems, including coma and death. Over time, high blood sugar can damage your eyes, heart, kidneys, blood vessels, and nerves.

Hypoglycemia

• If your blood sugar level drops just slightly below a safe range (mild low blood sugar), you may feel tired, anxious, weak, shaky, or sweaty, and you may have a rapid heart rate. If you eat something that contains sugar, these symptoms may last only a short time. If you have had diabetes for many years, you may not always notice symptoms of mild low blood sugar; this is called hypoglycemia unawareness. If your blood sugar is well-controlled and does not change much during the day, you may have an increased risk for hypoglycemic unawareness.
• If your blood sugar level continues to drop (usually below 40 mg/dL), your behavior may change, and you may feel more irritable. You may become too weak or confused to eat something with sugar to raise your blood sugar level. Anytime your blood sugar drops below 50 mg/dL, you should act whether you have symptoms or not.
• If your blood sugar level drops very low (usually below 20 mg/dL), you may lose consciousness or have a seizure. If you have symptoms of severe low blood sugar, you need medical care immediately.
• You may have symptoms of low blood sugar if your blood sugar drops from a high level to a lower level. For example, if your blood sugar level has been higher than 300 mg/dL for a week or so and the level drops suddenly to 100 mg/dL, you may have symptoms of low blood sugar even though your blood sugar is in the normal range. However, if you have had diabetes for many years, you may not have symptoms of low blood sugar until your blood sugar level is very low.

The Right Diagnosis and Treatment for Diabetes

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s Personal Approach to Diabetes

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, New York, NY 10017.