Which tests are conducted before treatment?

Before we begin the assessment, we take blood samples to ensure that your treatment will be optimal.

We check fasting blood sugar and long-term blood sugar (HbA1c). Elevated blood sugar is common in overweight individuals, and most people with type 2 diabetes are overweight.

It's the glucose level and long-term blood sugar (HbA1c) that are needed to assess the risk of diabetes. A normal glucose level is less than 6.1 mmol/L. The threshold for diabetes mellitus is two glucose values higher than 7.0 mmol/L if the sample is taken fasting. An HbA1c between 42-48 mmol/mol is elevated, and the threshold for diabetes is an HbA1c above 48 mmol/mol.

With weight loss and treatment with medications from the GLP-1 analog group like semaglutide, blood sugar and HbA1c decrease. The risk of diabetes decreases, and for those with diabetes, many can reduce or discontinue their other diabetes medications. We also check blood lipids (cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides).

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Elevated or abnormal lipid profiles increase the risk of cardiovascular diseases. With weight loss and/or treatment with medications, triglycerides and harmful LDL cholesterol decrease. We also assess your electrolyte balance and calcium balance (potassium, sodium, and calcium), your liver function tests (GT and ALAT), as well as albumin (protein levels in the blood) and kidney function tests (creatinine and eGFR). With weight loss, previously elevated liver values caused by fatty liver can often improve and normalise.

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Metabolic disorders are very common. In Sweden, millions of people take levothyroxine (thyroid hormone). Thyroid hormone deficiency leads to fatigue and sometimes weight gain. We check the pituitary test TSH and the thyroid hormone free T4 (thyroxine) to ensure that you have normal levels. We also check the blood count, hemoglobin level (Hb), the size of your red blood cells (MCV, MCH), your white blood cells (Leukocytes), and your platelets (thrombocytes).

These tests are often taken together and are called a blood count. The more red blood cells in the blood, the higher the Hb level becomes. Elevated Hb levels are sometimes seen in overweight individuals and in cases of obstructive sleep apnea syndrome. Blood disorders, iron deficiency, and bleeding can cause Hb levels to decrease. Iron deficiency is very common, so we also take another test to check for possible iron deficiency. It's called Ferritin. Additionally, we check your concentration of vitamin D in the body. This test is called 25-hydroxyvitamin D. A normal level of vitamin D is crucial for bone health and a normal immune system, among other functions. Vitamin D deficiency is common in overweight individuals, and in case of deficiency, overweight individuals may need higher doses of vitamin D to achieve normal concentrations in the blood.

We also check that you do not have a deficiency in other essential vitamins, such as vitamin B12 (cobalamin) or folic acid (folate), which are vital for many bodily functions, including blood formation and the nervous system.

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