Yearly Checkups – What to Include

People with diabetes need a yearly checkup to maintain optimum health. Early detection of various conditions is essential. Several exams and tests should be included in an annual diabetes checkup.

1. An A1C test measures the percentage of glycosolated hemoglobin (HbA1c) in your blood. Determining your average blood glucose control for the past three months verifies whether your diabetes plan is working. An A1C test should be done at least twice a year or possibly every three to four months.
2. A fasting lipid profile measures cholesterol in your blood including triglycerides, high density lipoprotein (“good” cholesterol) and low density lipoprotein (“bad” cholesterol). It helps determine your risk of heart, kidney and liver diseases as well as pancreatitis and hypothyroidism. According to ADA guidelines, total cholesterol should be <200 mg/dl. HDL should be >45 mg/dl in men and >50mg/dl in women, LDL <100 mg/dl or <70mg/ml, check with your MD and triglycerides <150 mg/dl.
3. A urine test is done to detect protein in the urine and check for kidney disease and other serious disorders. For random samples, normal results are about 0 to 8 mg/dl. For 24-hour urine collection, normal results are less than 80 mg per 24 hours. Urinalysis testing is done with test strips at home to check for ketones, a sign your body is using fat instead of glucose due to a lack of insulin. Record your results and discuss them with your diabetes health care practitioner.
4. A high serum creatinine level in your urine shows kidney function has slowed down. The results of a serum creatinine test are used to calculate glomerular filtration rate (GFR). Your GFR determines how much kidney function you have. A GFR below 30 means you should see a kidney disease specialist (nephrologist). A GFR fewer than 15 means you have kidney failure.
5. Body Mass Index (BMI) and Waist Circumference (WC) measure obesity and the increased risk of diseases such as diabetes. A BMI greater than 25 is overweight and over 30 is obese. A WC for women should be less than 35 inches and a WC for men should be less than 40 inches.
6. Blood pressure tests detect hypertension and other health risks. Blood pressure should be controlled at no higher then 130/80. Use blood pressure monitors at home to make sure your blood pressure is within the target range.
7. A dilated eye exam is done at least once a year to detect diabetic retinopathy that can lead to vision problems and even blindness with no symptoms.
8. A foot exam is done to detect diabetic neuropathy. Touch pressure sensation is measured by pressing a monofilament against part of your foot with your eyes covered.
9. Have a dental exam at least twice a year with a possible deep cleaning to remove bacteria from your gums that can cause problems such as heart disease and pneumonia.
10. Vaccinations should be up-to-date including measles/mumps/rubella- MMR, hepatitis A and B, chicken pox, polio, tetanus/diphtheria- DPT, influenza-flu shot and pneumonia (PPV).
11. Discuss stress management and mental health issues with your physician. People with chronic illnesses such as diabetes might be susceptible to depression and anxiety.

Annual checkups are essential for people with diabetes to remain healthy. They help you detect other conditions right away and develop a health care plan that works.