A diabetic female has elevated total calcium levels. Which test is crucial for evaluating this condition?

In the scenario presented, where a diabetic female has elevated total calcium levels, testing for serum albumin is crucial because total calcium levels can be influenced by the levels of serum albumin. Calcium exists in two forms in the bloodstream: bound to proteins (primarily albumin) and free (ionized). If there is a change in serum albumin levels, it can lead to misinterpretation of total calcium levels.

By measuring serum albumin, healthcare providers can calculate the corrected calcium level, which gives a more accurate reflection of the biologically active ionized calcium. This is particularly relevant in patients with dysproteinemia or conditions affecting protein levels, such as diabetes, where alterations in protein metabolism may occur.

Other tests, while potentially relevant in evaluating calcium metabolism, do not address the immediate concern of determining whether the elevated total calcium reflects a true hypercalcemia or is an artifact of altered protein level. Thus, serum albumin measurement is a fundamental step in the assessment of a patient with elevated total calcium.