If you have diabetes, you need to get more preventative checkups than most other people. This means more expense and trips to the doctor, but if you are diligent in making and keeping these appointments, you will protect your health.
Daily blood glucose checks
The American Diabetes Association (ADA) doesn’t say how often you need to use your meter to check your level, but it does say that the more often your check it, the better blood glucose level you will have. The ADA’s targets are for before meal levels to be below 130 mg/dl and two hours after starting a meal to be less than 180. But other organizations and doctors set tighter standards.
The A1C test
The A1C shows your average blood glucose level for the past two or three months. Although the ADA recommends an A1C level of seven percent as the goal for most of us, a level this high raises the risk of complications. A major clinical study found that when you keep your “A1C levels as close as possible to the normal value of six percent or less,” you reduce that risk. Most people need quarterly tests.
Every time you go to the doctor, a nurse will check your blood pressure. But if it is not well controlled, you can buy a home blood pressure instrument and test it more often. Most people with diabetes need to keep their levels below 140/90 mmHg, but the ADA recommends levels below 130/80 for some people, especially those with symptoms of kidney disease.
Everyone who has high blood pressure or Type 2 diabetes needs an annual test for the presence of microalbuminuria, which checks kidney function. People with Type 1 diabetes for five years or more also need this annual test. Checking the microalbumin/creatinine ratio is the most sensitive test, write Richard Jackson, M.D., and Amy Tenderich in their book. Normal is usually under 30.
Three key numbers of the lipid panel show if your cholesterol is too high. LDL cholesterol should be less than 100 mg/dl, but if you also have heart disease it should be below 70, says the Joslin Diabetes Center. For men, HDL cholesterol should be more than 40; for women, it’s more than 50. Triglyceride levels should be under 150. We need these tests at diagnosis and then every five years.
An ophthalmologist or a qualified optometrist must dilate your eyes as a part of a comprehensive eye exam to check for retinopathy. Adults with Type 1 diabetes need this within five years of diagnosis, but people with Type 2 should have it when they are diagnosed. If you have any retinopathy, you should be reexamined at least annually, but if you don’t, every two years is enough.
People with Type 2 diabetes need a foot exam to check for peripheral neuropathy upon diagnosis and at least annually. People with Type 1 need it five years after their diagnosis and then at least annually. It’s also a good idea to remind your doctor to check your feet every time you visit.
Diabetes is one of the major risk factors for periodontal (gum) disease, according to the American Dental Association. But unlike the other exams that people with diabetes need to get regularly, how often you should get a check-up depends on your dentist’s recommendation.
The influenza vaccine may not always prevent the flu, but it usually does. It also reduces the symptoms. A July 2016 study shows that it reduces the hospitalizations of people with Type 2 diabetes. No matter how old you are, experts recommend annual flu shots for all people with diabetes.
People with diabetes have a higher risk of dying from pneumonia, according to the Centers for Disease Control and Prevention. Everyone who has diabetes and is at least two years old needs to get the pneumococcal vaccine.
The last and easiest check-up — but the most important one — is keeping tabs on your weight. It’s the key factor in managing Type 2 diabetes. Every time you see a doctor, someone (usually a nurse) will weigh you and write down the number. But that’s usually it. You need to weigh yourself and regularly calculate your body mass index (BMI) to be sure it’s normal or at least trending in that direction.
Take responsibility for these tests
Don’t be satisfied with your doctor’s approximations of these results, write Dr. Jackson and Tenderich. “It is your right to request them,” they said in their book. It’s not easy to remember these tests and schedule when the next one is due. But if you take these preventative measures, you will increase your odds of staying healthy.