If you search on the internet for diabetes, you can quickly find a lot to scare you. Rather than get overwhelmed with what could happen, make sure you understand what you can do to prevent your diabetes from getting worse. This know the results of these 8 tests and what to do if they are abnormal will go a long way to preventing diabetes complications. The tests you should have this year include:
- A1c. Hemoglobin A1c or HbA1c tells you and your doctor how well your diabetes has been controlled over the last 3 months. Normal is 5% or less. Your doctor will likely ask you to make lifestyle changes or changes to your medication regimen if your A1c is above 7%. Lower A1cs are associated with less complications of the eye, kidney, and nerves.
- Blood pressure check. Elevated blood pressure or hypertension has been called the silent killer. Persistent systolic blood pressure greater than 130 mmHg or diastolic blood pressure greater than 80 mmHg is compatible with hypertension. Your blood pressure can be really high and you may not experience any symptoms– so you need to check it regularly. Like diabetes, poorly controlled hypertension can lead to heart disease and stroke. Elevated blood pressure is treated with a combination of lifestyle changes and medication.
- Cholesterol check. This will include a blood test checking for both cholesterol and triglycerides and will need to be preformed while fasting. If your cholesterol levels are high, you may need treatment with medication in addition to lifestyle modification. If cholesterol is too high you are at increase risk for heart attack and stroke.
- Eye exam. Diabetes is the leading cause of blindness in the U.S. You should have a dilated (the doctor or optometrist will use drops to widen you pupils and better see the back of the eye) eye exam at least yearly. Diabetes can damage the retina (called diabetic retinopathy) and the exam is to look for any early signs of this complication. If diabetic retinopathy is not treated you can lose vision or even become blind.
- Foot exam. Diabetes can lead to nerve damage over many years. I am not referring to nerves like anxiety, but the nerves that allow you to feel. The medical term is neuropathy and you basically experience impaired sensation. Patients experiencing nerve damage from diabetes may not be able to feel that they have injured their foot. This can lead to infection and even amputations if not treated appropriately. Your doctor will often assess sensation with a monofilament test at least once per year.
The doctor will have you close your eyes and say yes when you feel the monofilament on your foot. They will preform the test on several parts of the foot. Additionally, your doctor should inspect your feet for sores at each visit.
- Urine for protein. Diabetes is also the leading cause of permanent kidney damage that requires dialysis. This test is looking to see if you are spilling albumin or microalbumin into your urine, which occurs if diabetes has damaged your kidneys. A number of different treatments can slow progression, but it is essential that your diabetes be under good control.
- Creatinine. This blood test tells your doctor how well your kidneys are functioning. Creatinine is a waste product normally excreted by the kidney. When the kidneys are damaged and not working, creatinine build up in the blood stream causing the levels to elevate. Your doctor will get this test at least yearly. Again medical treatments are available, but good glucose control is essential.
- Oral health assessment. Poor diabetic control is associated with oral complications such as gingivitis (gum disease), periodontitis (extension of gum disease to underlying structure and bone), dry mouth, and oral infections. Your dental health professional can help you prevent and treat any complications of diabetes.