Thursday, May 23, 2013

Diabetes

Table of Contents

Prevention

Maintaining an ideal body weight and an active lifestyle may prevent type 2 diabetes.

Currently there is no way to prevent type 1 diabetes.

There is no effective screening test for type 1 diabetes in people who don't have symptoms.

Screening for type 2 diabetes in people with no symptoms is recommended for:

  • Overweight children who have other risk factors for diabetes starting at age 10 and repeating every 2 years
  • Overweight adults (BMI greater than 25) who have other risk factors
  • Adults over 45, repeated every 3 years

To prevent complications of diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.

Regularly have the following tests:

  • Have your blood pressure checked every year (blood pressure goals should be 130/80 mm/Hg or lower).
  • Have your glycosylated hemoglobin (HbA1c) checked every 6 months if your diabetes is well controlled, otherwise every 3 months.
  • Have your cholesterol and triglyceride levels checked yearly (aim for LDL levels below 100 mg/dL, less than 70 mg/dL in high-risk patients).
  • Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
  • Visit your ophthalmologist (preferably one who specializes in diabetic retinopathy) at least once a year, or more often if you have signs of diabetic retinopathy.
  • See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.
  • Make sure your health care provider inspects your feet at each visit.

Stay up-to-date with all of your vaccinations and get a flu shot every year in the fall.


References

Alemzadeh R, Wyatt DT. Diabetes Mellitus. In: Kliegman RM, ed. Kliegman: Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders;2007:chap 590.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62-S69.

American Diabetes Association. Standards of medical care in diabetes -- 2010. Diabetes Care. 2010; 33 Suppl 1:S11-S61.

Eisenbarth GS, Polonsky KS, Buse JB. Type 1 Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 31.


Review Date: 05/10/2010
Reviewed By: Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)