Diabetes mellitus type 1 laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]


Laboratory findings consistent with the diagnosis of type 1 DM include FPG ≥126 mg/dL (7.0 mmol/L), or 2-h PG ≥200 mg/dL (11.1 mmol/L) during an OGTT, or A1C ≥6.5% (48 mmol/mol), or classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).

Laboratory Findings

Laboratory findings consistent with the diagnosis of type 1 DM include:[1][2][3]

ADA Criteria for the diagnosis of diabetes
FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h.*
2-h PG ≥200 mg/dL (11.1 mmol/L) during an OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.*
A1C ≥6.5% (48 mmol/mol). The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.*
In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).

↵* In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing.

Laboratory findings in type 1 diabetes based on presentation
Classic new onset Diabetic Ketoacidosis
Blood Glucose
  • Random: random (nonfasting) plasma glucose concentration of 200 mg/dL or higher
  • Fasting plasma glucose concentration of 126 mg/dL (6.99 mmol/L) or higher
Random glucose level is more then 250 mg/dl
HbA1C HbA1c level of 6.5% or higher Not applicable
C-Peptide below below 5 µU/mL Not applicable
Islet-cell (IA2) Measurements of IA2 autoantibodies within 6 months of diagnosis can help differentiate between type 1 and type 2 DM Not applicable
Anti-GAD65 Usually present Not applicable
Anti-insulin autoantibodies Usually present Not applicable
CBC with differential Normal Mildly elevated with normal differential
Basic metabolic panel Normal Serum bicarbonate < 18 mEq/L

Serum Sodium: Often normal or elevated

Serum Phosphate: Often normal or elevated

Serum Potassium: Often normal or elevated

Serum Creatinine Normal Often elevated
Serum calicum Normal Decreased
Serum amylase Normal Mildly elevated
Serum Lipase Normal Normal
Serum osmorality Normal Normal
Serum Ketones Normal High
Anion gap normal High
Arterial Blood gas Normal Metabolic acidosis, compensated by

respiratory alkalosis

Urine Glucose May or may not be present, (blood glucose should be more then 200 mg/dl to appear in urine) Often present
Ketones absent Present
                                          FPG-new.gif OGTT
                                           FPG                          OGTT


  1. Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016
  2. "NIDDK".
  3. Karaguzel G, Ozer S, Akcurin S, Turkkahraman D, Bircan I (2007). "Type 1 diabetes-related epidemiological, clinical and laboratory findings. An evaluation with special regard to autoimmunity in children". Saudi Med J. 28 (4): 584–9. PMID 17457482.
  4. Notkins, Abner Louis (2002). "Immunologic and Genetic Factors in Type 1 Diabetes". Journal of Biological Chemistry. 277 (46): 43545–43548. doi:10.1074/jbc.R200012200. ISSN 0021-9258.

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