Help for T2D? Endo appt - which tests to request?

RalfLott

Dear LCD gurus,

I have an appointment coming up with a well-regarded endocrinologist, and I'm wondering what I should request in the way of tests beyond the common panels and blood tests (A1c, lipids, liver function, B-12, etc).

• First, I'm wondering whether insurance will cover uncommon tests (insulin, IgA, glucagon, leptin, extensive thyroid/iodine....);
• Second, are there other tests I should consider asking for?

Thanks in advance for sharing your collective wisdom!

wabmester

Depends on your specific concerns. Last time, I asked for a fasting insulin test because I was curious. I was warned that insurance might not cover it, and I could be out of pocket $100 or so.

(BTW, if you're taking insulin for T2D, you probably want a C-peptide test instead of insulin.)

My hands were cold, so I also got TSH tested.

Tell your doc your concerns, and they'll recommend specific tests.

RalfLott

wabmester wrote: »

Depends on your specific concerns. Last time, I asked for a fasting insulin test because I was curious. I was warned that insurance might not cover it, and I could be out of pocket $100 or so.

(BTW, if you're taking insulin for T2D, you probably want a C-peptide test instead of insulin.)

My hands were cold, so I also got TSH tested.

Tell your doc your concerns, and they'll recommend specific tests.

Thanks, especially for the tip to fast before the appointment.

Normally, I would want to go in with my own list, but I think this specialist will know what to do.

Q - I'm not on insulin, but is there still a point to a C-peptide test?

wabmester

C-peptide is just a precursor to insulin. It tracks endogenous insulin, so it can be used if your insulin levels would be affected by exogenous sources. That's my understanding, anyway.

KnitOrMiss

I personal would do the insulin test no matter if I had to pay out of pocket or not. I'd probably also get the C-Peptide test, too, for a better picture.

It really depends on what you're wanting to ask this endo about.

There are a number of tests for thyroid. You might end up needing gut biome tests. D3 is a critical one for me, always, in addition to B12... Hormone panel affects all of this stuff, too. Definitely cortisol so you can determine if that's a factor in your glucose numbers. I don't know how much iodine results are legit - because I felt better when my iodine was way high, though I'm leveling out now that my doc is increasing my thyroid meds as my iodine gets back to normal range (was supplemented before)...

I would more make a list of any conditions/actions you're concerned about before you go in. Talk to your doc about your concerns, decide which tests together.

RalfLott

KnitOrMiss wrote: »

I personal would do the insulin test no matter if I had to pay out of pocket or not. I'd probably also get the C-Peptide test, too, for a better picture.

It really depends on what you're wanting to ask this endo about.

There are a number of tests for thyroid. You might end up needing gut biome tests. D3 is a critical one for me, always, in addition to B12... Hormone panel affects all of this stuff, too. Definitely cortisol so you can determine if that's a factor in your glucose numbers. I don't know how much iodine results are legit - because I felt better when my iodine was way high, though I'm leveling out now that my doc is increasing my thyroid meds as my iodine gets back to normal range (was supplemented before)...

I would more make a list of any conditions/actions you're concerned about before you go in. Talk to your doc about your concerns, decide which tests together.

Thanks - much appreciated.

I don't have any real complaints at the moment, but I'd prefer to avoid/forestall any and all future complications, including prescriptions.

(If I hadn't tested my BG by pure happenstance, I might have walked around like an oblivious popsicle for months to come!)

wabmester

RalfLott wrote: »

(If I hadn't tested my BG by pure happenstance, I might have walked around like an oblivious popsicle for months to come!)

Blood sugar regulation is apparently the last to go haywire in a cascade of trouble. If you want metrics of improving health: waist circumference (visceral fat), liver function (ALT should give you a clue), HDL (and the TG/HDL ratio), BP, and perhaps CRP are the ones to watch.

RalfLott

Bump. Anyone have any tests to add?

nvmomketo

You mentioned this in another post, but growth hormone, tested as IGF-1, can be linked to higher FBG numbers and may be one to test if FBG is unexplainably high.