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What Does The Following Test Report Indicate?

Posted on Thu, 19 Jan 2017

Question: Dear Sir ,
Today i had a test for Mom attached the results for the same
Following results were not as per as Normal Level.Could you please suggest if you need to take any tablets to remove the deficiency

HbA1c 8.9
AVERAGE BLOOD GLUCOSE (ABG) 209 mg/dl
BLOOD UREA NITROGEN (BUN) Result Was 7.08 ( Normal Range 7.9 - 20)
ALKALINE PHOSPHATASE PHOTOMETRY 132 (Normal Range F:42 to 98)
LIPOPROTEIN (A) [LP(A)] NEPHELOMETRY mg/dl 58.7 (Normal Range < 30.0 )mg/dl
25-OH VITAMIN D (TOTAL) C.L.I.A 23.88 (Normal Range 23.88 30-100 ng/ml)

Answered by Dr. Dr. Abhay A Mali (1 hour later)

Brief Answer:
Calcium, Vitamin D supplement and Statin may be suggested.

Detailed Answer:
Hi,

Thanks for your question.
Noted your concern.

After going through your mom's reports I may suggest-
* HbA1c 8.9:
For better blood sugar control continue current medicines advised by her treating doctor.
Recheck Fasting and post-prandial blood sugar levels after 2 to 3 weeks and accordingly any changes in medicines can be suggested.

* BUN:
It is one of parameter of kidney function.
It is absolutely normal report there is nothing to worry.
It should not be above normal limit.

* Alkaline Phosphatase:
It is related to kidney function and bone turn over and calcium metabolism.
Other parameters of liver function are absolutely normal.
As such elevated Alkaline Phosphatase may not always require treatment.
Calcium and Vitamin D supplement may help.

* Lipoprotein (A):
It is related to blood vessel changes (development of atherosclerosis - Blockages).
It is a part of Bad cholesterol LDL which is also elevated in her case.
(In diabetics LDL cholesterol should be below 100).
For this use of Statin cholesterol lowering drugs will help.
Use of Atorvastatin or Rosuvastatin may be suggested.

* 24 OH Vitamin D:
It is in insufficient range.
Correction with use of powder or tablet containing Cholecalciferol 60k once week for 6 to 8 week may be suggested.

Hope this helps.

Regards,
Dr. Abhay Mali.
Diabetologsit.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Dr. Abhay A Mali (1 hour later)

Thank you very much for your detailed Answer.Its really Helpful.Do we have any side effects of taking Supplements related to to Vitamin D and Statin. Reason im asking is that My mother is having diabetes .Just wanted to make sure that it is safe to take under Diabetes Medication.
I was planning to take R.I.S.C Test fr Mom from Lifespan http://www.lifespanindia.com/what-is-risc.html does it make sense to take the test from there else these results would be enough to determine the complication related to diabetes ?
Thanks in advance.

Answered by Dr. Dr. Abhay A Mali (51 minutes later)

Brief Answer:
Statin is one of the essential medicine in patients with diabetes.

Detailed Answer:
Vitamin D supplement rarely have any significant side effects.
Irrespective of lipid levels Statin is a essential medicine in patients with diabetes after age of 35 years.
When compared with beneficial effects there side effects are negligible.
Better to start it with consultation with her treating diabetologist.

Beside all above tests I may suggest-
- Early morning urine albumin creatinine ratio for screening nephropathy.
- Consult ophthalmologist for fundoscopy for screening of retinopathy.
- Get ECG and 2DEcho done for screening of heart issue.
- Detailed history taking and clinical examination including foot examination by her treating doctor.

I may consider this will be enough for her, though final decision rests on her treating doctor.

Hope this helps.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Abhay A Mali (2 days later)

Thank You very much for your answer.sorry for the delay in reply.
Could you please suggest which statin tablet is safe to take for diabetes paitents or do we have any natural drugh which would be safe to take for diabetes.
We would perform those test suggested by you and would get back yo you

Answered by Dr. Dr. Abhay A Mali (16 hours later)

Brief Answer:
I may suggest Rosuvastatin.

Detailed Answer:
Sorry for delayed reply.
In such a scenario I may suggest Tablet containing 10 mg of Rosuvastatin one tablet at bed time.
As it is a prescription medicine better to consult her doctor.

Hope this helps.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Dr. Abhay A Mali (2 days later)

Dear Sir,
As per your request we have done the following results attached the results for the same :-
Get ECG and 2DEcho done for screening of heart issue.
Early morning urine albumin creatinine ratio for screening nephropathy.

Request you to review and give the feedback about the results
thanypu very much for your help

Answered by Dr. Dr. Abhay A Mali (21 hours later)

Brief Answer:
Check her blood pressure.

Detailed Answer:
Sorry for delayed reply.

After going through current reports there is
- Fairly controlled blood sugar levels continue current treatment recheck blood
sugar levels after 1 month.
- 2DEcho suggest changes of high blood pressure. Consult her treating doctor for blood pressure check up accordingly appropriate anti-hypertensive medicine in appropriate dose can be started.
- Other tests including urine albumin creatinine ratio are within normal limits.

Hope this helps.

I will happy to answer your future queries if any.
You can directly ask questions to me on following link-
http://www.HealthcareMagic.com/doctors/dr-abhay-a-mali/69954

Above answer was peer-reviewed by : Dr. Remy Koshy