The basic metabolic panel (BMP) tests for various indicators of metabolic functioning, including blood sugar (glucose) level, electrolyte and fluid balance, and kidney operation. Glucose, calcium, sodium, potassium, carbon dioxide, chloride, urea nitrogen, creatinine, and the glomerular filtration rate (GFR) are also included in the BMP, which is primarily used to detect and diagnose conditions such as diabetes and kidney disease. Doctors may also order this panel of tests to determine if a medication is working properly or throwing certain lab values out of balance. For example, diuretics used to treat high blood pressure may affect electrolyte balance and the kidneys, so a BMP test is frequently recommended for patients taking these drugs. Some BMP tests require fasting for at least eight hours prior to having your blood drawn, so be sure to ask your health practitioner for pretesting instructions.
One of the biggest problems with BMP tests is that “trending” lab values—numbers that technically fall within the normal range but are headed in the wrong direction—are rarely discussed with patients. In other words, “low normal” and “high normal” lab values are not typically treated as health concerns. Instead, the usual approach is to watch and wait for a trending lab to finally become abnormal. By this time, a disease or other medical condition has very often already developed.
A Kaiser Permanente Study that tracked over 46,000 people for a decade demonstrated the limitations of this approach. According to the study, for every one-point rise in fasting blood sugar over 84 mg/dL, an individual’s risk of diabetes increases by about 6 percent. This may seem like only a slight increase, but by the time blood glucose levels reach 90 to 94 mg/dL, the risk of developing diabetes increases by 49 percent. And if blood glucose levels reach the highest normal range of 95 to 99 mg/dL, the risk of diabetes is more than doubled.
Why is this so shocking? Because the “normal” range for fasting blood glucose levels is 65 to 99 mg/dL, which means that lab values which may actually warrant further consideration are treated as normal. More alarming is the fact that when fasting blood sugar reaches a level of 90 mg/dL—a value technically within the “normal” range—vascular and kidney damage can begin to develop in the body. For the most part, doctors do not inform patients about concerns regarding their blood glucose until their level reaches 100 mg/dL, when—according to the Kaiser Study—their diabetes risk has already climbed to a staggering 84 percent. These statistics are a testament to the critical importance of blood tests and why you should become knowledgeable about your labs and always inquire about your results, even when you are told they are normal. Monitoring and managing trends is just as important as treating abnormal blood values. In the case of BMP tests, reversing a trend with diet, lifestyle changes, and even supplements can help prevent the development of diabetes and kidney disease, among other medical conditions.
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