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What Do These Following Lab Reports Indicate?
Question: there has been a rise in my lipase during last three months to 97 ansd my amylase is 70. Everything else is normal except HbA1c that has jumped from 6.5 to 8.5. latest blood sugar reading on one touch meter went to 247 whereas my normal is always below 200. My urine has nil sugar and no protein or ketones as tested by strips.
Your comments and advice please
XXXXXXX XXXX british national currently living in Goa XXXXXXX
Your comments and advice please
XXXXXXX XXXX british national currently living in Goa XXXXXXX
Brief Answer:
Diabetes - needs treatment
Detailed Answer:
Hello Sir,
Thank you for your query. I understand your concerns.
I have gone through your reports in detail.I would appreciate if you can go through my answer in detail and reply to my queries.
1) Are you having any abdominal pain? Are you able to digest food well? Can you flush your stools easily in the toilet? What was your previous lipase level?
I would not worry much about your lipase levels. Lipase can be upto 120-180 and still considered as normal. Your amylase is in normal range.
2) Your blood glucose has increased as you mentioned. You mentioned you have tried Metformin 500 mg before, how many tablets of metformin were your taking in a day and when did you stop taking the metformin? Why did you stop the metformin?
Are you having any other medical problems like raised blood pressure? Are you on any other medications? Can you provide me a complete list of your medical history and any other medicines that you take? What is your height and weight?
3) Your haemoglobin is in normal range, but your MCV is borderline high. Can you provide me your previous Haemogram report (I mainly want your previous MCV-mean corpuscular volume report)? Do you drink alcohol – if yes then how much?
4) Your serum bilirubin (liver function tests) is borderline. Do you have any jaundice? I would not worry much about this bilirubin at this moment in time, as rest of your liver function tests are normal. You could just repeat the LFT in 6 weeks’ time.
5) Rest of your reports are all normal.
So plan:
- Kindly reply back to the questions mentioned, and I can suggest you further.
- You definitely need medication for your diabetes. Based on what you reply, I can advise you the treatment.
- Repeat your LFT and lipase levels in 6 weeks’ time.
I look forward for your reply.
Regards
Dr Sunita Sayammagaru
Diabetes - needs treatment
Detailed Answer:
Hello Sir,
Thank you for your query. I understand your concerns.
I have gone through your reports in detail.I would appreciate if you can go through my answer in detail and reply to my queries.
1) Are you having any abdominal pain? Are you able to digest food well? Can you flush your stools easily in the toilet? What was your previous lipase level?
I would not worry much about your lipase levels. Lipase can be upto 120-180 and still considered as normal. Your amylase is in normal range.
2) Your blood glucose has increased as you mentioned. You mentioned you have tried Metformin 500 mg before, how many tablets of metformin were your taking in a day and when did you stop taking the metformin? Why did you stop the metformin?
Are you having any other medical problems like raised blood pressure? Are you on any other medications? Can you provide me a complete list of your medical history and any other medicines that you take? What is your height and weight?
3) Your haemoglobin is in normal range, but your MCV is borderline high. Can you provide me your previous Haemogram report (I mainly want your previous MCV-mean corpuscular volume report)? Do you drink alcohol – if yes then how much?
4) Your serum bilirubin (liver function tests) is borderline. Do you have any jaundice? I would not worry much about this bilirubin at this moment in time, as rest of your liver function tests are normal. You could just repeat the LFT in 6 weeks’ time.
5) Rest of your reports are all normal.
So plan:
- Kindly reply back to the questions mentioned, and I can suggest you further.
- You definitely need medication for your diabetes. Based on what you reply, I can advise you the treatment.
- Repeat your LFT and lipase levels in 6 weeks’ time.
I look forward for your reply.
Regards
Dr Sunita Sayammagaru
Above answer was peer-reviewed by :
Dr. Kampana
Dear Dr. Sayammagaru
Thank you for your prompt reply.
In response to your questions, my replies are:-
1/. I am not having any abdominal pains. My digestion is working perfectly and it is regular daily motion with no flushing problems. I am attaching my previous Thyrocare report in October 2016. I have regular 3-montly blood tests.
2/. I was originally on JANUMET 1000 in April 2016 but changed to Metformin 500 about 14 months ago as Janumet was causing various side effects to my appetite. I have not stopped Metformin 500 although I may go on the same Metformin 500 to twice a day instead of one tablet a day. There are no side effects from Metformin.
My blood pressure is normal even after food and bit of travel to doctor by car.
I am taking asomax 2.5 mg once a day for blood pressure. Vitamin D3 2K once a day because my Vitamin D3 went down to 9 about an year ago. It is well above normal now. I am taking Atorva Statin 10 mg for Cholestrol. I weigh myself on an empty stomach every morning on an accurate digital scale. My height is 5’-7” and my weight is 71 kg +/- 0,6 kg depending on my food intake previous day.
3/. The information in question is in the attached previous report.
4/. I do not have jaundice. I have about 120 ml of RED wine before lunch every day with a small amount of peanuts. In the evening I have 60 ml imported spice rum with a dash of sugar free/salt and water with juice of half a lemon.
I am booked with a local hospital for a full “Senior Citizen’s Check” and Arthritis Check on 25 April. That would include the necessary blood test and X-ray etc.
I will perform another “ONE TOUCH BLOOD TEST” tomorrow morning after a full 12 hour fasting. As I already advised you, my urine (which I test every morning with test strips) is nil sugar, nil ketone and nil protein. I also have a lab test of my urine every 6 weeks and the last test was 100% OK with no adverse report.
Many thanks
Thank you for your prompt reply.
In response to your questions, my replies are:-
1/. I am not having any abdominal pains. My digestion is working perfectly and it is regular daily motion with no flushing problems. I am attaching my previous Thyrocare report in October 2016. I have regular 3-montly blood tests.
2/. I was originally on JANUMET 1000 in April 2016 but changed to Metformin 500 about 14 months ago as Janumet was causing various side effects to my appetite. I have not stopped Metformin 500 although I may go on the same Metformin 500 to twice a day instead of one tablet a day. There are no side effects from Metformin.
My blood pressure is normal even after food and bit of travel to doctor by car.
I am taking asomax 2.5 mg once a day for blood pressure. Vitamin D3 2K once a day because my Vitamin D3 went down to 9 about an year ago. It is well above normal now. I am taking Atorva Statin 10 mg for Cholestrol. I weigh myself on an empty stomach every morning on an accurate digital scale. My height is 5’-7” and my weight is 71 kg +/- 0,6 kg depending on my food intake previous day.
3/. The information in question is in the attached previous report.
4/. I do not have jaundice. I have about 120 ml of RED wine before lunch every day with a small amount of peanuts. In the evening I have 60 ml imported spice rum with a dash of sugar free/salt and water with juice of half a lemon.
I am booked with a local hospital for a full “Senior Citizen’s Check” and Arthritis Check on 25 April. That would include the necessary blood test and X-ray etc.
I will perform another “ONE TOUCH BLOOD TEST” tomorrow morning after a full 12 hour fasting. As I already advised you, my urine (which I test every morning with test strips) is nil sugar, nil ketone and nil protein. I also have a lab test of my urine every 6 weeks and the last test was 100% OK with no adverse report.
Many thanks
Brief Answer:
Increase Metformin dose
Detailed Answer:
Hello Sir,
Welcome back to HealthcareMagic.
Thank you for answering my questions. I have checked your previous reports.
1) As you are not having any abdominal pain and have no other problem with digestion or with your stool, I would not worry much about your raised lipase now. As explained yesterday lipase can be around 120-180 and still considered as normal. Kindly get it repeated in 8-12 weeks and we will see how it goes.
2) Regarding your diabetes, you could increase your Metformin to 500 mg twice a day and recheck your FPG and PPG in 2 weeks. If still, the blood glucose is high, then increase the dose to 1000 mg twice a day and recheck your FPG and PPG in a further 2 weeks. If the values are still high, you may need other medications to be added.
You can continue your other medications as mentioned. Your weight seems fine.
3) Raised MCV can be due to excess alcohol intake (it can be due to other causes like B12, Folate deficiency, hypothyroidism, liver disease etc – but these are normal in your case). It looks like you are drinking about 3.5-4 units of alcohol per day. Can you reduce the amount of alcohol consumption and recheck your haemogram in 2-3 months?
Once you reduce your alcohol intake, your blood glucose values may reduce too.
4) Your previous Liver function tests also show a slightly borderline high Bilirubin. In absence of jaundice and other liver parameters being normal, I would not worry much about this as it is only very mildly elevated. You can just repeat it in 2-3 months and then see the trend. If the bilirubin is remaining at the same level, then nothing much needs to be. If it increasing, then you may need to have an ultrasound scan.
5) Your urine report is fine.
Action for you to take:
- Increase your Metformin 500 g twice a day and then to 1000 mg twice a day. If glucose values which are finally checked at 4 weeks still remain high still, then an additional medication is needed.
- Reduce alcohol consumption.
- Recheck your lipase, LFT, and haemogram in 2-3 months.
I hope this answer has been helpful to you.
Regards
Dr.Sunita Sayammagaru
Increase Metformin dose
Detailed Answer:
Hello Sir,
Welcome back to HealthcareMagic.
Thank you for answering my questions. I have checked your previous reports.
1) As you are not having any abdominal pain and have no other problem with digestion or with your stool, I would not worry much about your raised lipase now. As explained yesterday lipase can be around 120-180 and still considered as normal. Kindly get it repeated in 8-12 weeks and we will see how it goes.
2) Regarding your diabetes, you could increase your Metformin to 500 mg twice a day and recheck your FPG and PPG in 2 weeks. If still, the blood glucose is high, then increase the dose to 1000 mg twice a day and recheck your FPG and PPG in a further 2 weeks. If the values are still high, you may need other medications to be added.
You can continue your other medications as mentioned. Your weight seems fine.
3) Raised MCV can be due to excess alcohol intake (it can be due to other causes like B12, Folate deficiency, hypothyroidism, liver disease etc – but these are normal in your case). It looks like you are drinking about 3.5-4 units of alcohol per day. Can you reduce the amount of alcohol consumption and recheck your haemogram in 2-3 months?
Once you reduce your alcohol intake, your blood glucose values may reduce too.
4) Your previous Liver function tests also show a slightly borderline high Bilirubin. In absence of jaundice and other liver parameters being normal, I would not worry much about this as it is only very mildly elevated. You can just repeat it in 2-3 months and then see the trend. If the bilirubin is remaining at the same level, then nothing much needs to be. If it increasing, then you may need to have an ultrasound scan.
5) Your urine report is fine.
Action for you to take:
- Increase your Metformin 500 g twice a day and then to 1000 mg twice a day. If glucose values which are finally checked at 4 weeks still remain high still, then an additional medication is needed.
- Reduce alcohol consumption.
- Recheck your lipase, LFT, and haemogram in 2-3 months.
I hope this answer has been helpful to you.
Regards
Dr.Sunita Sayammagaru
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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