Patient Care

This test measures your average blood glucose for the past couple of months. It doesn’t require you to fast or drink a special liquid. If you have an A1C of 6.5% or more you have diabetes. If the A1C is more than 7 then urgent action is required to control diabetes in order to prevent complications

This diagnostic test requires you to fast for at least eight hours before the test. An FBS will test your fasting blood glucose levels. If your levels are 126 mg/dl or higher, you will be diagnosed with diabetes. FBS also indicates how good or bad your control is.

 This is a blood test that can be done at any time. If the test reports a blood glucose of greater than or equal to 200 mg/dl, you will be diagnosed with diabetes.

is done at the visit to see the fluctuation in glucose levels. If it is more than 140 then diabetes targets are not being met. In older adults a more relaxed 180 is taken as a target.

this test can be done fasting 9 to 14 hours or even random for us to monitor your progress. Lipid profile is used to evaluate your risk of heart attacks in future and to guide which medications are required to prevent heart attacks.

These include a creatinine, estimated Glomerular filtration rate (eGFR), and urine microalbumin. Together these 3 tests look at kidney function and risk of future kidney problems if any. Based on these tests a kidney protection plan is then initiated- which may include diet changes, control of A1C and blood pressure as well as medications to protect the kidneys.

This is a digital photograph of your retina (back of th e eye)- the most important part of the eye that helps you ‘see’. Retina is damaged by diabetes and high blood pressure and monitoring the retina for any damages is an essential part of diabetes care. We do an initial imaging as well as follow up images later to check and follow up the progress. If there are problems with the retina you may require additional tests such as ocular computed tomogram (OCT) to more carefully study the retina and macula of the eye.

These tests check your feet. Diabetes is the number one cause of amputation of the feet or legs! However the good news is that amputations are preventable. At DHC we take care of your feet to give you a mobile future on your own feet. Neuropathy Tests include check of your skin, nerves and blood vessels for any abnormalities in the feet and legs. Based on the findings an appropriate foot care plan is made- this includes tinctures for the nails, creams for the feet, special footwear as appropriate, and medications based on the findings. Sometimes a vascular surgery consultation may be needed based on what we find in the blood vessels of the feet.

For those with thyroid illness thyroid function tests are done. These include TSH, Free T4 and Free T3, in addition thyroid autoantibodies may be measured as well as thyroglobulin which is a tumour marker. Imaging of the thyroid is done with Ultrasound scan of thyroid if required. The other imaging studies that we may need include a CT Scan of thyroid and sometimes an XRay. In patients with thyrotoxicosis or nodules a Tc99 nuclear scan may be required. If there is a suspicious nodule a fine needle aspiration cytology of thyroid ( FNAC test is done to risk stratify the nodule.

 in women with menstrual abnormalities, excessive hair growth or acne a comprehensive evaluation is made to look at the underlying hormonal abnormality. The tests often include LH, FSH both of which control the ovaries, Testosterone level which may be increased in those with acne, or excessive hair growth, Prolactin level which may indicate a pituitary problem, 17 OH Progesterone which may indicate an adrenal gland abnormality.

In those with suspected pituitary problems a variety of pituitary hormones are checked. These include: Cortisol, TSH, T4, Prolactin, LH FSH, Growth Hormone, and IGF-1. Sometimes dynamic pituitary tests are done. Imaging of pituitary is usually with an MRI scan of Pituitary.

 These tests are required for those with suspected osteoporosis or calcium disorders. Osteoporosis Assessment is done with a DEXA scan and FRAX score while the calcium control is studied with Calcium, phosphorous, alkaline phosphatase, vitamin D level, and Parathormone (PTH) tests. If relevant further tests such as bone turnover markers, urine calcium excretion and imaging of parathyroid glands with 4D CT or SestaMIBI scan is done. PTH venous catheter is done in some patients to evaluate for the parathyroid gland abnormality.

Adrenal functions are evaluated by hormone tests in the blood or urine as appropriate. The tests include: Cortisol, Testosterone, 17 OH Progesterone, ACTH, Renin, Aldosterone, Metanephrine, Normetanephrine as well as Urine Metanephrine, and Urine normetanephrine. Imaging of the adrenal gland is done with CT scan adrenal protocol or MRI scan.

 Based on the clinical scenario these may include LH FSH Testosterone Estradiol and SHBG.