Don't Forget Your Diabetes Check-ups

Good Health Depends on Good Care

A patient has her blood pressure taken.
A patient has her blood pressure taken. digitalskillet/Getty Images

Regular check-ups are an important tool in managing diabetes—whether you are feeling great or not. Check-ups measure your overall health, provide education and guidance on diabetes self care, and help you to prevent and treat diabetes complications. Depending on your overall control you may be asked to come in for a check-up once or twice a year. If you are experiencing any complications, you will need to be seen more often. In addition to seeing your primary doctor, you may also have to see other specialists.

Blood Tests and Physical Examination

During a diabetes well visit or sick visit, you'll have blood drawn and your physician will examine you. The most common labs drawn include:

  • Hemoglobin A1c
  • Creatinine and BUN levels
  • Cholesterol levels

Your phsycian will also measure your:

  • Weight
  • Blood pressure
  • Pulse

And they should check your:

  • Feet and lower extremities check
  • Eyes

Hemoglobin A1c

The A1c test will tell you your average blood glucose level over the course of a three month period. Making sure that your A1c is in your target range helps you keep your risk for complications lower. The American Diabetes Association (ADA) recommends an A1c of less than 7%, while the American Association of Clinical Endocrinologists (AACE) advises an A1c of less than 6.5%. The normal range for people without diabetes is between 4% and 6%. People with prediabetes fall between the range of 5.7%-6.4%.

Creatinine and Blood Urea Nitrogen (BUN) levels

Blood tests can show how your kidneys are functioning. Creatinine and BUN are waste substances that are dumped into the blood by cells for excreting by the kidneys. When the kidneys aren't working as well, these can build up in the blood, forcing levels to rise. If your kidney function tests are coming back abnormal your primary doctor may refer you to a nephrologist.

Cholesterol Levels: HDL, LDL and Triglycerides

Why check your cholesterol? Because people with diabetes are twice as likely to develop heart disease. Glucose in the blood can slow down the LDLs ("bad" cholesterol) which makes them sticky. This causes cholesterol to build up much faster on blood vessel walls. Cholesterol-lowering medications are usually prescribed earlier for people with diabetes to prevent complications of heart disease. Elevated LDL and triglycerides are increase the risk of developing heart disease and atherosclerosis. Additionally, lower HDL levels can also be problematic.

If your cholesterol levels are out of range your phsycian may suggest that you make dietary changes, lose weight, exercise or in more significant cases, take medication.

If there are other issues related to your heart, you maybe referred to an cardiologist.

Blood Pressure

High blood pressure is known as the "silent killer." People with diabetes tend to have trouble with high blood pressure, too. Having both diabetes and high blood pressure can cause an increase in the risk of heart disease, stroke, and eye, kidney and nerve complications. Blood pressure medications keep the risks down. Additionally, eat a diet that is lower in sodium and including, more nutrient dense foods which are rich in vitamins and minerals can help to reduce risk.

Feet and Legs

Decreased circulation and changes in the blood vessels of your feet and lower legs can cause serious problems. Even though you should check your feet daily for fungas, nail and toe deformities, cuts, sores, or infections, your health care provider should also assess them at your check-up visit. A microfilament or tuning fork exam can detect decreased sensation to asses the risk of neuropathy (loss of feeling in the feet). Neuropathy, decreased circulation, and poor blood glucose control can inhibit the ability to heal cuts and sores.If cuts and sores become infected, the complications can be devastating. The risk of gangrene increases as circulation becomes compromised and the body can't fight off infection. Amputation of the affected limb is often the result.

A foot exam can help you to keep your feet healthy. If your phsyician notices an issue, such as a fungas, or a foot deformity they can refer you to a podiatrist.

If you have a history of peripheral arterial disease, your legs are swollen, red, and you have foot issues, your physician may recommend that you see a vascular surgeon for further workup.

Eyes

Everyone with diabetes should have a comprehensive eye exam at diagnosis and if no issues are found they can see an opthalmologist again one-to-two years later. When blood glucose levels remain too high for a long period of time, changes can occur in the tiny blood vessels that supply the retina of the eye. This is called retinopathy. Damage isn't always easy to detect, so getting your eyes checked regularly can help spot trouble before it gets out of hand. If retinopathy is not treated, it can lead to blindness. Anytime that you notice strange blotches, blurriness, or dark spots in your vision, you should make an appointment with an eye doctor immediately.

A Word From Verywell

Protect yourself against developing diabetes complications by making your ongoing diabetes check-up appointments. Most people with diabetes should see their primary doctor, an opthalmologist, and a podiatrist, sometimes are also referred to an endocrinologist (a doctor who specializes in diabetes). If you are experiencing other complications you may be referred to other specialists.

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