Diabetes: Tests/Exams you should have

[SamanthaNY]

While talking with some friends who happen to be diabetics, I was shocked to learn that they were not aware of some very important yearly tests they should be having. Shockingly, some of these tests are also missed or ignored by many doctors. If you have diabetes, here's what you should be doing:

(Important note: these are in addition to tests and exams that should be part of a yearly physical)

Yearly eye exam: "diabetes is the leading cause of adult blindness in our country, the dilated eye exam is another important test that should be done every year to prevent blindness or eye damage"

Yearly foot exam: "Diabetes can cause nerve damage and numbness, as well as decreased circulation that makes it harder for your body to fight infection. Patients with numbness problems may not notice if they injure a foot. A resulting infection may not heal well, and skin and other tissue may die. In a small minority of cases, the problem progresses into a complication that requires amputation."

Daily at-home blood glucose testing: As recommended by your doctor.

Kidney function test: Obesity and diabetes can both negatively impact kidney function. "Get an annual urine test to check for the presence of protein, as well as a blood test at least once a year to check for creatinine. These tests indicate how well your kidneys are working."

Blood pressure measurement: "Have blood pressure checked at every medical appointment. The goal for people with diabetes is less than 130/80 if they have no complications from the disease. If complications are present, the goal is lower: 125/75"

Hemoglobin A1c test: "This diabetes blood test, also called HbA1c, tells you and your doctor how well diabetes is managed over time. It measures your average blood sugar in the previous three months to see if it has stayed within a target range."

24-hour urine catch analysis: (thanks to the lovely Michelle for adding this!) When done at first diagnosis, this sets baseline levels for kidney function - extremely useful in judging kidney function over time.

Colorectal exam: At age 50 if there is no cancer in family members - earlier if there is a history of cancer in the family. "A recent study of 200,000 Americans released in November 2005 by Donald Garrow, MD, a clinical research fellow at the Medical University of South Carolina, concluded that diabetics are 1.4 times more likely to be diagnosed with colon cancer than nondiabetics."

Yearly or bi-yearly dental exam/cleaning: (credit to the lovely jamie for this one) "Periodontal disease is often linked to the control of diabetes. For example, patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than persons who have good control of their diabetes. It is possible to have periodontal disease and not have all of the warning signs. If you notice any of the warning signs of gum disease, see your dentist immediately." See here for a good faq on diabetes and your teeth.

In addition, there are clinical tests that your doctor should be doing. A good list is here.

Print out this list and discuss it with your doctor. Tests may be a nuisance, but learning how to protect yourself before conditions get out of hand is far preferable to dealing with the consequences of avoiding tests.

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