Exams & tests for managing diabetes

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A nurse takes the blood pressure of a patient

Your daily routine is important. You can do daily tasks at home on your own or with the help of family or friends. These include foot and skin checks, taking your medications, planning what and when you eat, and testing your blood sugar. This section is about the regular check-ups and health care tasks you need to complete throughout the year.

To help you keep track, you can download and print a “Diabetes Care Record” for your personal use.

  • Plan your tests, exams, shots, and other visits.
  • Write down the results of each test, exam, or shot.
  • Take this chart with you to every appointment so you can follow up on any questions or concerns you have.

Medical appointments at least twice a year

Seeing your doctor is an important part of improving your care routine and avoiding problems. Ask your doctor how often you should schedule your visits, and then go to all of your appointments.

Along with your doctor, you may also partner in these visits with care team members such as specialists, nurses, nutritionists, a diabetes educator, and a care manager.

Each medical appointment will include general checks on your health, including specific tests and exams. Your doctor and care team will also review with you your personal action plan and goals for managing your condition.

If you have specific concerns or questions, be sure to ask your care team for answers and advice.

Tests and exams to schedule

At least twice a year

  • A1C test
  • Dental exam
  • Dilated eye exam or retinal screening photo (based on results, this checkup may change to once a year)

Once a year

  • A complete foot exam
  • Cholesterol test
  • Flu shot
  • Kidney check (microalbumin)

At least once in your life

  • Pneumonia shot (added booster shots may be needed)
  • Hepatitis B shot series

More details on tests and exams

Below are more details about each kind of checkup that may be part of your medical appointments.

Foot exam

With diabetes, problems can happen without you knowing about it. Injuries don’t always heal quickly, and small things can develop into infections. Feet are particularly at risk. For that reason, checking your feet carefully and daily is essential.

A complete foot exam is also performed 1 to 2 times a year at your regularly scheduled medical appointments. Your doctor will do this exam as well as treat injuries and arrange for certain foot care to be done by a medical professional.

See Caring for your feet  for details on how to check your feet.

Review of your personal action plan

Learning how to manage diabetes is a gradual process. Having a personal action plan will help you succeed.

You and your doctor can use your action plan to decide what areas you need to improve on so you can be in the best health while living with diabetes. The items in your personal action plan will change as you manage these areas.

Weight check

Obesity lowers the effectiveness with which your body uses insulin. That directly affects diabetes.

Tracking your weight and BMI (body mass index) number gives you and your doctor the numbers you need to reduce diabetes risks related to your diet and exercise.

Blood pressure check

Blood pressure is the force that your blood moves through your body. Everyone’s blood pressure goes up and down in response to what they’re doing and how they’re feeling. If it stays too high or too low, however, that can be a problem.

High blood pressure can add to the risk of strokes.

Test: Blood pressure monitoring

Purpose: To track your blood pressure so you learn how it responds to what you’re doing or feeling. This helps you and your doctor fine-tune your daily life to get your blood pressure right where you want it.

How this check is done: A blood pressure cuff is fit around your arm. The monitor automatically inflates and deflates the cuff while recording your results.

Results: There are 2 numbers the monitor records:

  • Systolic pressure, which is how hard blood is pushed by your heartbeats
  • Diastolic pressure, which is how hard blood is pushed between heartbeats

Results are the systolic and diastolic numbers separated by a slash. For example, “120/80,” which is read as "120 over 80.” 

Your target blood pressure is a personal goal that you and your doctor will decide on.

Review of your medicines

Part of managing diabetes is making sure you’re taking the right medicines in the right amounts at the right times. It’s also important to know how over-the-counter drugs can affect your prescription medications.
Your regularly scheduled appointments with your doctor are the times to update your prescriptions and resolve any medication problems you may be having.

A1C

Test: Hemoglobin A1C (blood test)

Purpose: To measure how much sugar is attached to your red blood cells. A red blood cell lives for 3 to 4 months – the results of this test is an average of your blood sugar over that time. 

How this test is done: A sample of blood is drawn from your arm (or sometimes a finger prick). A lab technician studies how much sugar is in your plasma.

Results: A1C test results are shown as a percentage of sugar in a specific amount of plasma:

For most people, the target level for the A1C test is less than 7%. Your doctor will help you identify a healthy range for your own results. 

Dental exam

High levels of blood sugar can increase the risk of:

  • Periodontal (gum) disease
  • Tooth decay
  • Thrush or other fungal infections in the mouth
  • Dry mouth (which can cause gum disease and tooth decay)

Having a daily home routine of tooth care and checking your gums for redness or sores is critical. Regular dental checkups are also important so your dentist can also look for signs of trouble.

Dilated eye exam or retinal screening photo

Diabetic retinopathy is when high blood sugar damages the blood vessels to the retina (the light-sensitive tissue at the back of the eye). At first, it can cause changes in your vision, then later lead to blindness.

Test: Dilated eye exam or retinal screening photo

Purpose: To look closely for signs of irritation or damage to the retina, blood vessels, and optic nerve of the eye. These may be “silent” problems that you don’t have any idea are there. Regular exams and tests can help your doctor find problems early. 

How this exam is done: A member of your care team puts drops in your eyes to widen (dilate) the pupils. This makes it easier to see inside your eye.

While your eyes are dilated, a retinal screening photo may be taken to review more closely. This also creates a history to compare how your eyes have changed in photos taken over time.

Results: In these tests, damage to the eyes can appear in the following ways:

  • Detached retina
  • Increased pressure
  • Swelling
  • Unexpected physical changes to blood vessels, the retina, or the optic nerve
  • Bleeding

Cholesterol test

You always need some fat in your diet. Different kinds of fats and fatty substances build cells, make hormones, and store energy.

3 key types of fat are: 

  • HDL (high-density lipoprotein), or “good cholesterol” 
  • LDL (low-density lipoprotein), or “bad cholesterol” 
  • Triglycerides, “good” unless their level gets too high

Having too little good cholesterol or too much bad cholesterol and other fat in your blood can add to your risk of heart disease, heart attacks, or strokes. Even if you have good cholesterol levels, your doctor may still want you to take cholesterol-lowering medication to help your circulation and prevent these health risks.

Test: A lipid panel (blood test)

Purpose: To measure how much cholesterol and other fat is in your blood. Knowing these numbers will help you and your doctor manage the fats you include in your diet.

How this test is done: A sample of blood is drawn from your arm or hand. A lab technician measures how much fat is in a specific amount of that blood sample.

Results: Cholesterol and fat levels are measured in milligrams per deciliter (mg/dL). Good targets are:

  • HDL cholesterol – 40 mg/dL or higher
  • LDL cholesterol – Less than 100 mg/dL
  • Triglycerides – Less than 150 mg/dL

Shots (vaccinations)

Getting sick can be very serious for people with diabetes because it can raise the blood sugar. Follow the recommended schedule to defend yourself against illness.

  • Flu shots (yearly)
  • Pneumonia shot (one-time for life)
  • Hepatitis B (one shot series for life)

NOTE: Added booster shots may be needed to protect you more fully from these illnesses.

Kidney function test

Albumin is a protein made by the liver. Among other chores, it carries hormones, medicines, and vitamins throughout your body.

Healthy kidneys keep albumin out of urine, so finding albumin in urine could be a sign that the kidneys may not be working well. People with diabetes have a risk of kidney disease. 

Test: Microalbumin (urine test)

Purpose: To measure how much albumin is in a urine sample. Running this test once a year helps your doctor stay on top of this risk.

How this test is done: A small urine sample is collected at one time, or a larger amount can be collected over a period of 4 to 24 hours. A lab technician studies the urine sample to see how much albumin it has.

Results: Test results are measured in micrograms per milligram (mcg/mg). The important result is the microalbumin/creatinine ratio. The target result of this test is less than 29.9 mcg/mg of creatinine.

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