Courtesy Centers for Disease Control
For people with diabetes, itâ€™s easy to get caught up in the day-to-day management of the disease. Regular monitoring of blood sugar levels, injections or pumping insulin and diet management takes serious time and effort. No wonder why people with diabetes (PWD) may feel overwhelmed when it comes to taking regular tests.
Itâ€™s important to step back regularly to see how overall health is faring since diabetes is a systemic disease. It can affect nearly every part of ones body. Before diving into the list of tests, people with diabetes need to understand what these tests mean and identify their target results with their healthcare professional.
Here is a list of the most critical tests with standards set by the National Institutes of Health and the American Diabetes Association.
This is the test everyone talks about, for a good reason. An A1C lets you know what your average blood sugar is for the past 2-3 months. Never mind the daily fluctuations — the A1C gives you the broadest overall picture.Â¨ This is important because your overall health will be determined by your long-term management. So if you A1C is low and consistent, you know youâ€™re doing a good job, even if you sometimes have challenges in your daily management. If your A1C swings around, or goes high, you know that youâ€™ll need to tweak your treatment plan.
Whatâ€™s a good A1C? According to the American Diabetes Association, diabetics should aim for a 7 percent or below. According to the American Society of Endocrinologists, you should aim for a 6.5 or below. Some doctors urge even lower numbers; A1Cs for non-diabetics are generally below 6 percent.
Unlike the other blood tests listed here, youâ€™ll want to have an A1C performed four times a year.
This is another crucial test for people with diabetes, for the simple reason that cardiovascular issues (heart attacks and strokes) are the most serious potential side effects of the disease. Other complications can cause serious problems, yes, but a healthy heart is of critical importance.
Cholesterol is a complex topic. Many books have been written on the topic, and there is medical disagreement about how to interpret the results. Hereâ€™s a quick summary of the current thinking.
A cholesterol test is really measuring several different components of blood fats, and they have different levels of importance. Take the overall cholesterol, which is usually the largest number youâ€™ll see. This number is actually of little importance on its own because it includes both “goodâ€ and “badâ€ cholesterol.
“Badâ€ cholesterol is called LDL (or low-density lipoprotein) and doctors will want to generally keep it below 100. That being said, there are different kinds of LDL particles, some of which are more harmful than others.
The “goodâ€ cholesterol is called HDL (or high-density lipoprotein), and doctors generally want to keep it above 40. Again, though, it seems as though there are also different kinds of HDL particles, some of which are more beneficial than others.
People with diabetes will also be tested for triglycerides, which are yet another kind of blood fat. Doctors will want that number to be below 150.
Doctors pay different attention to these numbers. They often focus on LDL cholesterol because they have effective drugs (statins) that can reliably reduce it. That being said, evidence exists that HDL and triglycerides are more powerful predictors of cardiovascular issues. Raising HDL levels usually takes regular exercise, weight loss and dietary change.
Cholesterol levels donâ€™t fluctuate in the way that A1C levels do (unless one dramatically changes their diet), they will be tested less frequently. People with diabetes will generally get one test a year, unless their doctor wants to keep a closer watch on the levels.
There are two important tests diabetics must have regularly to measure kidney function. This is crucial because kidney disease (and potential failure) is one of the most serious potential diabetic side effects.
The best-known of these is the microalbumin test. This looks for protein in your urine. High blood sugars can damage the tiny, delicate blood vessels in the kidneys, causing trace amounts of protein to leak into the urine. Over time, if not addressed, this damage can progress to full-blown kidney failure and dialysis.
Doctors will also want to test blood creatinine levels. This number indicates how effectively the kidneys are filtering waste products. Taken with the microalbumin test, the doctor should be able to get a good idea of ones overall kidney health.
Of all diabetic complications, kidney problems have been one of the most effectively prevented and reduced. In part, this is because ACE inhibitors, a common blood pressure medication, help prevent kidney damage. Even if you donâ€™t have kidney problems (or high blood pressure, for that matter), your doctor may want you to start an ACE inhibitor for just this reason.
Oneâ€™s blood pressure is checked at every doctorâ€™sâ€™ visit, and thatâ€™s as it should be. The test is quick and easy to perform and it gives you immediate results. Itâ€™s another test that gives you insight into cardiovascular health, so one needs to pay attention to the elevated numbers.Ã¢€Â¨ In general, doctors will diagnose high blood pressure if the readings are above 140 systolic (the top number) and 90 diastolic (the bottom number). For most people, the numbers should be closer to 120/80.
Diabetes can raise blood pressure and there are generally no symptoms if youâ€™re suffering from elevated levels blood pressure. There are cheap and effective drugs for lowering blood pressure. Doctors will probably want a person with diabetes on medication, even if ones numbers are borderline or mildly elevated.
At least twice a year, people with diabetes should also have a foot exam. Their doctor will look at their feet carefully to make sure you donâ€™t have any ulcers or abrasions. These can be especially risky for people with diabetes with impaired circulation. Doctors will also check the pulse in the feet, another measure of the circulation in the extremities.
Finally, Oneâ€™s health care provider will likely test how sensitive their feet are, usually with a small plastic thread called a monofilament. This can help diagnose impaired sensation.
If one is diagnosed with foot problems, their doctor may recommend special shoes to reduce pressure on sensitive spots. Medication can also be prescribed if one is suffering from pain caused by nerve damage.
Dilated eye exam
People with diabetes need to go to an eye doctor for this exam. An eye exam looks specifically for the retinal damage that can be caused by high blood sugars. Surgery to seal off leaking blood vessels may be needed to preserve and protect ones vision.
The good news about eye complications is that they tend to be one of the earliest signs of poorly controlled diabetes. Good glycemic control has been shown to stop these problems and sometimes even reverse them.
General health exam
Health canâ€™t be reduced to one disease or set of complications. Ones overall wellness is important too. Thatâ€™s why people with diabetes should have a general checkup at least once a year, in addition to all of the aforementioned tests. The doctor will let the one know how their overall health is faring and what they can do to stay on track.
Why bother with these tests?
Going through this list of tests seems daunting. It makes having diabetes seem like a parade of drudgery, of constant trips to the doctor. And people with diabetes will tell you– thatâ€™s definitely an aspect of managing the disease. Itâ€™s not fun, and it can be nerve-wracking to wait for ones results.
But the good news embedded in this list of tests is that nearly any problem that is detect can be addressed. If issues are found early, simple and effective treatments exist. Even moderate to severe complications and problems can often be treated and resolved.