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Diagnostics of diabetes mellitus in adults including pregnant
ŠTĚRBOVÁ, Eva
Diabetes mellitus is worldwide spread chronical disease which affects both sexes and all age groups. If the disease is not treated it can cause hard damage to various systems or even kill. The thesis is divided into two parts. The objective of the first, theoretical part, was to bring closer the problems of diabetes mellitus, its classification and complications. Simultaneously, the possibilities of laboratory diagnostics of the disease were described. The objective of the second, empirical part was to assess if glycohemoglobin was a suitable compensation of oral glucose tolerance test as a marker of impaired glucose tolerance. For the thesis the data of 94 patients investigated at the Laboratory of Clinical Chemistry in Nemocnice České Budějovice, a. s. (Hospital České Budějovice Inc.) were used. The patients were divided into two groups: the group called ``Pregnant{\crqq} (51 pregnant women) and the group called ``Others`` (43 people). In both groups oral glucose tolerance test was carried out and glycohemoglobin was determined. The level of glucose in blood was determined by a fotometric enzymatic method at the analyzer ADVIA 1650 Chemistry system, glycohemoglobin was determined by effective liquid chromatography at the analyzer TOSOH A1c 2.2 (HLC 723 Ghb V, G5). The group of pregnant cannot be reliably evaluated because only one woman was diagnosed gestational diabetes mellitus according to oral glucose tolerance test. In the group of Others impaired glucose tolerance according to oral glucose tolerance test was proved in 14 individuals, 5 of them had increased glycohemoglobin and 9 individuals had glycohemoglobin in referential range. Diagnostic sensitivity, specificity a effectiveness at cut off 4,0 % was counted for glycohemoglobin. Sensitivity was 36 %, specificity 96 % and effectiveness 73 %. The results show that the use of oral glucose tolerance test as a marker of impaired glucose tolerance is still more suitable than the use of glycohemoglobin which does not have sufficient sensitivity for the diagnosis of the disease.
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