What does the blood report of a diabetic patient indicate?

Question

Hello doctor,

I am writing this for my brother. He has diabetes and has been taking medicine for the last three years. He recently came home for a short vacation and underwent health check-ups. After studying the reports, our family doctor pointed out elevated values like hemoglobin. The doctor suggested consulting a hematologist. Soon, we consulted a hematologist, who advised him to do specific laboratory tests. The reports are ready except for one, which is JAK2 ARMS-PCR. We are worried about him. Kindly go through the attachment and advise us with your valuable opinion. Does he have any serious health-related issues? Your prompt reply will be much appreciated.

Thanks.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have read the attached report of your brother (attachment removed to protect patient identity). The main abnormal findings in the CBC (complete blood count) report are elevated red blood cells and PCV (packed cell volume). The hemoglobin level is also raised slightly. So, it is suggestive of polycythemia. It can be secondary, which is more common, or primary. The primary type includes bone marrow problems, which your brother has been instructed to investigate with a JAK2 study. It will help in ruling out primary polycythemia. The secondary cause includes respiratory disease, cardiac disease, chronic smoking, dehydration, etc. So, if any such history or smoking history is present, kindly mention it to guide you further. I suggest you drink lots of water, at least 0.5 to 0.7 gallons daily. He needs to stop smoking if he has a habit of it.

Additionally, I suggest you investigate with chest X-ray, EKG (electrocardiogram), and serum erythropoietin estimation for further workup. Kindly revert with reports once done, including JAK2. He must repeat CBC after 15 days to check red blood cells and PCV values. Do not worry. Most such cases are secondary polycythemia. You can discuss all these with your treating hematologist. Additionally, I want to point out that your brother's diabetes is not controlled. He needs to be given a combination of two drugs, and his lifestyle needs to be changed to control sugar.

I hope this information will help you.

Thanks.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

It is good that you are aware of the health of your brother. I have checked the attached reports. Both reports are within range. Polycythemia means increased red blood cell production and so hemoglobin as well, along with high PCV. It is divided into two types.

1. Primary polycythemia, which is a blood cancer. It is a myeloproliferative neoplasm. In most cases, JAK2 is positive if primary polycythemia is present.

2. The secondary polycythemia is due to respiratory and cardiac causes, smoking, and dehydration.

So in your brother's case, JAK2 is negative. Hence, blood cancer seems very unlikely. It can be some form of secondary polycythemia. Do not worry about that. However, it is advisable to investigate with a chest X-ray to exclude a respiratory cause and an EKG (electrocardiogram) to exclude a cardiac cause. Advise him to drink 12 cups of water per day. He needs to repeat his CBC (complete blood count) after 30 days to check his red blood cell count, PCV (packed cell volume), and hemoglobin level.

I hope this information will help.

Thanks.