Blood glucose testing is the process used to measure the concentration of glucose in your employee's blood. A blood test involves pricking their finger with a small needle called a lancet, drawing a drop of blood from the finger and applying it to a test strip that has been engaged into a blood glucose meter.
Monitoring of blood glucose can be a beneficial part of diabetes detection and management. As part of the day-to-day routine it can help with necessary lifestyle and treatment choices as well as help to monitor for symptoms of hypo- or hyperglycaemia.
HbA1c detailed diabetes test
HbA1c or Haemoglobin A1c is also known as glycosylated haemoglobin and is a longer term measure of glucose levels in your blood than a simple blood glucose test. Glucose attaches itself to the haemoglobin in red blood cells, and as cells live for around 8 - 12 weeks, it gives us a good indication of the level of sugar in the blood over a 2 - 3 month period.
This is an important measure for diagnosing type 2 diabetes as well as understanding how well blood sugar levels are being controlled in someone with diabetes.
Cholesterol is an essential body fat (lipid). It is necessary for building cell membranes and for making several essential hormones. Cholesterol is manufactured in the liver and also comes from the food we eat. Excessive cholesterol is a risk factor for heart disease - doctors like to see levels below 5 mmol/L.
However, cholesterol is made up of both good (HDL) and bad (LDL) cholesterol so it is important to investigate a raised total cholesterol to see the cause. High levels of HDL cholesterol can cause a raised result but actually be protective against heart disease.
HDL % of total cholesterol
HDL cholesterol (high density lipoprotein) removes cholesterol from the bloodstream and transports it to the liver where it is broken down and removed from the body in bile. HDL cholesterol is commonly known as "good cholesterol". Raised levels are protective against heart disease, while low levels are associated with increased risk of a heart attack.
non-HDL cholesterol (non-HDL-C) has become a commonly used marker for a blood lipid pattern associated with increased risk of heart disease.
It is helpful to know your non-HDL cholesterol because your level of non-HDL may predict your risk of cardiovascular disease even better than your LDL (bad) cholesterol.
That’s because your non-HDL number tells you all the bad cholesterol circulating in your blood – not only your LDL cholesterol but also your levels of VLDL, IDL, and chylomicrons. All are linked with the “bad” protein – ApoB, which means all are plaque-producing and artery-clogging.
LDL cholesterol (6 hour fasting)
LDL Cholesterol (low density lipoprotein) carries cholesterol, triglycerides and other fats to various tissues throughout the body. Too much LDL cholesterol, commonly called "bad cholesterol", can cause fatty deposits to accumulate on artery walls potentially leading to atherosclerosis and heart disease.
Triglycerides (6 hour fasting)
Triglycerides are a type of fat (lipid) that circulate in the blood. After you eat, the body converts any excess calories into triglycerides which are then transported to cells to be stored as fat. Your body releases triglycerides to be used for energy.
Raised triglycerides are thought to be a risk factor for peripheral vascular disease (affecting the blood vessels which supply your arms and legs as well as organs below the stomach) as well a microvascular disease, affecting the tiny blood vessels around the heart.
Kidney function (3 tests)
Sodium is both an electrolyte and mineral. It helps regulate the water (inside and outside the body's cells) and electrolyte balance of the body. Sodium is also important in how nerves and muscles work. Sodium in the blood is regulated by the kidneys. Too much sodium in the blood is often due to dehydration but can be a marker of the kidneys not working properly. Too little sodium is often caused by fluid retention (oedema) or too much sodium lost through vomiting and diarrhoea or excessive sweating.
Urea is waste product produced as the body digests protein and is carried by the blood to the kidneys, which filter the urea out of the blood and into the urine.The urea test shows how well the kidneys are working. A high amount of urea in the blood may indicate dehydration or that the kidneys are not working properly or simply that you consume a high protein diet. Low amounts of urea in the blood may indicate a low protein diet, over-hydration, malnutrition or liver failure.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Measurement of this is an indicator of the level of other waste products. Creatinine is an accurate marker of kidney function. Elevated creatinine can be caused by high intake of animal protein, taking creatine supplements and vigorous exercise but could also indicate that the kidneys are not working properly.
Low creatinine can be caused by a low protein diet, reduced muscle mass or merely efficient kidney function.
Alkaline Phosphatase (ALP) is an enzyme located mainly in the liver and bones. High levels can indicate bone or liver disease. Raised ALP is looked at in conjunction with other liver function tests to determine whether the problem lies in the liver or the bones. Pregnancy can also cause raised ALP and it is often elevated in growing teenagers.
Aspartate Transferase (AST) is an enzyme created mainly by the cells of the liver and the heart. Any injury to the heart or liver, and other bodily tissues will cause AST to be released into the bloodstream. Levels can be raised following a heart attack, or from liver damage caused by alcohol, drugs or viruses (hepatitis). AST can be raised after vigorous exercise.
Alanine Transferase (ALT) is an enzyme which is produced by the liver and can indicate liver damage caused by alcohol, drugs or viruses (hepatitis). Small amounts of ALT are normal, but raised levels may mean that your liver is inflamed. Raised levels can also be caused by recent vigorous exercise.
CK (Creatinine Kinase) is a muscle enzyme which measures muscle cell damage and death. CK levels tend to be higher in people with greater muscle mass. CK levels are measured to assess muscle damage, CK levels can rise rapidly after muscle trauma, but will subside as the damage repairs. Levels which continue to rise indicate that muscle damage is continuing. If you have been to the gym the day before your blood test you may well have raised levels of CK.
Gamma GT is a liver enzyme which is raised in liver and bile duct diseases. It is used in conjunction with the ALP to distinguish between bone or liver disease. Gamma GT is used to diagnose alcohol abuse as it is raised in 75% of long term drinkers.
Bilirubin is a product of haemoglobin breakdown. It is removed from the body via the liver, stored and concentrated in the gall bladder and excreted into the bowel. Raised bilirubin can cause the skin and whites of eyes to become yellow (jaundice) as the liver is unable to remove sufficient bilirubin from the blood. This can indicate liver damage. Bilirubin can also be raised due to a blocked bile duct as well as Gilbert's syndrome.
The Iron test measures how much iron is in your blood with the aim of identifying iron deficiency anaemia or iron overload syndrome (haemochromatosis) The symptoms of too much or too little iron can be similar: fatigue, muscle weakness, moodiness and problems concentrating. A raised result can mean that you have iron overload syndrome, an inherited condition where your body stores too much iron, or that you are over-supplementing or that you have a liver condition. A low result can mean that you are anaemic or are suffering from gastro-intestinal blood loss (or other blood loss). Anaemia is also very common in pregnant women.
Total Iron Binding Capacity (TIBC) is a measure of the amount of iron that can be carried through the blood. A raised TIBC result usually indicates iron deficiency whereas a low TIBC can occur with iron overload syndrome (haemochromatosis).
Transferrin is made in the liver and is the major protein in the blood which binds to iron and transports it through the body. Low levels of transferrin indicate iron deficiency while high levels indicate iron overload.
Uric acid is a waste product of protein digestion. High levels can lead to excess uric acid being deposited as crystals in the tissues of the body. When this occurs in joints it causes the painful condition known as gout. Uric acid levels are best tested 6 weeks after symptoms appear as they may not be raised at the beginning of an attack.
Total Protein represents the sum of albumin and globulin. It is more important to know which protein fraction is high or low than what the measure of total protein is.
Albumin is made mainly in the liver and helps to keep the blood from leaking out of blood vessels. It also helps carry some medicines and other substances through the blood and is important for tissue growth and healing. Low albumin levels can indicate liver disease and can also be a marker for chronic ill-health, malnutrition and inflammation. It can also occur in kidney conditions such as nephrotic syndrome and diabetes. Raised levels are usually caused by dehydration.
Globulin consists of different proteins and is made by the liver and the immune system. Certain globulins bind with haemoglobin while others transport metals, such as iron, in the blood and help fight infection.
Thyroid Function - TSH & thyroxine
The thyroid is one of the largest endocrine glands in the body. It controls all of the chemical and hormonal processes in the body including how quickly the body uses energy, makes proteins, and how sensitive the body is to other hormones. It does this by secreting hormones, predominantly thyroxine (T3) and tetraiodothyronine (T4). Hormonal output is regulated by thyroid-stimulating hormone (TSH) secreted by the anterior pituitary. In some cases the thyroid does not function normally, it can either be over or under active, which is hyperthyroidism and hypothyroidism respectively. Hypothyroidism can occur from congenital thyroid abnormalities, autoimmune disorder, hormonal changes and thyroid removal. The most common symptoms are weight gain and fatigue, which can be caused by a variety of factors, so often goes undiagnosed.
Although called a vitamin, vitamin D is actually a hormone which is activated by sunshine on your skin. Vitamin D is essential for bone strength as it helps your intestines absorb calcium. However, it is thought that vitamin D also plays an important role in immune function, as well as in many chronic diseases and mental health.
Many people in the UK do not produce enough Vitamin D, especially in the winter months with fewer daylight hours. It is now recommended that you get 10 - 15 minutes of unprotected sun exposure every day to ensure you are producing enough vitamin D. In winter months, if your levels are found to be low, you may wish to take a supplement.