By Beth Michaels – In-house Dietitian
Having type 2 diabetes can be overwhelming. Not only are you expected to make drastic changes to your diet and lifestyle, but when you go to the doctor, talk with friends, and start doing a bit of research, conversation can start to sound like a foreign language.
Statements like “What’s your A1c?” or “Have you had any lows?” sound like gibberish to the average person but these become increasingly important to someone with diabetes. There are a variety of tests that help you monitor the progression (or regression!) of your condition.
Here’s the rundown:
1. Hemoglobin A1c (HbA1c)
What it is: Think ‘bird’s eye’ view. The HbA1c measures the percentage of red blood cells that have sugar attached to them. The higher the percentage, the higher the sugar level. Since red blood cells have an average 90 day lifespan, this test gives you an idea of how your blood sugars have been averaging over the past 3 months and there is little day-to-day variation.
When to do it: Every 3-6 months depending on how well controlled your diabetes is.
Targets: 6.5% (more aggressive) to 7% (more liberal) depending on the individual, his/her treatment plan, and realistic expectations.
2. Self Monitoring Blood Glucose (or SMBG)
What it is: Your daily home testing is more like walking through the forest, examining all the trees and wildlife and day to day variation. This value is continually changing based on what you eat, when you exercise, how well you’ve slept, whether you’re stressed, etc.
When to do it: This will vary from a couple times per week to 12 or more times depending on the individual. Values should be recorded in a logbook and reviewed at every office visit.
Targets: Between 90-110 (5-6.1) fasting (before a meal). Less than 140 (7.8) after meals.
3. Blood Pressure
What it is: The amount of force required by your heart to pump blood through your arteries. Higher pressure indicates greater stress on the heart and increases risk for heart disease. Activities that constrict blood vessels (such as smoking) increase this as well.
When to do it: Every office visit and daily at home for some.
Targets: Less than 120/80
4. Lipid Panel
What it is: This is a group of blood tests revealing the body’s ability to metabolize lipids (or fat). Having values out of target can increase risk for heart disease.
When to do it: Every 1-2 years if controlled, every 6 months if high risk. Remember to be sure to FAST 12 hours prior to the test.
Targets: Cholesterol: <200; Triglycerides: <150; HDL: >40; LDL: <150
5. Urine Protein (and estimate GFR)
What it is: This is an indicator of kidney function. Over time, excreting excess sugar can damage the kidneys.
When to do it: Every year.
Targets: <30 ug/mg Creatinine
6. Comprehensive (dilated) eye exam:
What it is: High sugar in the blood can cause damage to tiny vessels in the eyes resulting in glaucoma, cataracts and other vision problems. Regular comprehensive exams will detect any actual or potential problems and allow for early treatment options.
When to do it: At diagnosis and every 1-2 years thereafter.
Targets: Normal healthy eyes.
7. Comprehensive Foot Exam
What it is: Neuropathy in type 2 diabetes is very common over time and loss of sensation may result in unnoticed infections and wounds. Getting feet checked with a monofilament at office visits as well as checking your feet daily with a mirror for any cuts, bruises, discoloration will help to prevent problems. See our foot care guide over here.
When to do it: Every office visit (at least once/year) and checking feet daily at home (very important).
Targets: Healthy circulation, no loss of sensation, no bruises, cuts, dry skin or abnormalities.
8. Dental Exam and Cleaning
What it is: Gum disease is more common in people with diabetes.
When to do it: Twice annually.
Targets: Healthy teeth and gums, free of plaque, cavitations, or infection.
9. Flu and Pneumococcal Vaccine
What it is: Diabetes increases risk for complications associated with influenza and pneumonia as the body’s ability to fight infections is weakened resulting in higher rates of hospitalization and death.
When to do it: Flu: Annually Pnemonia: One to twice in a lifetime depending on your age of diagnosis and whether you have had a previous shot.
Having regular health checks and diagnostic tests is very important and can help you avoid any complications associated with your type 2 diabetes.
And, if you’re being proactive and working on changing your diet and lifestyle, your tests provide a benchmark for what’s working and what’s not, helping you make the adjustments necessary as you continue your health journey.
Denial is never a good choice. So whatever you do, don’t put your head in the sand. Get your tests and keep yourself if good health.
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