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Diabetes Testing

Your Schedule

Many of us with diabetes feel better now than before our diagnosis. That’s probably mostly because we take better care of ourselves now and get more exercise.

But much of the reason is because we now take an active role in managing our health. We’ve learned that neither our doctors or anybody else can do that for us.

A big part of taking care of ourselves is to schedule the tests and check-ups that we regularly need. They range from daily to multi-year.

The American Diabetes Association tells doctors the schedule for their patients with diabetes in a position statement on Standards of Medical Care in Diabetes. This dense document is excellent – as far as it goes. But it doesn’t go far enough, because it’s for doctors and it’s people with diabetes like you and me who need to make sure we follow the schedule.

Daily Blood Glucose Testing
How often you need to test depends mostly on whether you take insulin or not. If you take more than one shot of insulin a day, the position statement says you need to test at least three times daily. It’s less specific about people who take only a daily shot of insulin or pills, but as I wrote in an earlier blog all the evidence points to the need to test at least once a day.

Quarterly A1C Testing
Since the A1C test measures your average blood glucose over the past 2 to 3 months, most people need to get it measured about once a quarter.

Daily Exercise
This is one that I have to keep reminding myself to do. My daily schedule always contains a reminder to me to take a walk or – if the weather is bad – to work out on my treadmill.

Annual Flu Shot
The influenza vaccine may not always prevent the flu, but it usually does. It also reduces the symptoms. As usual, I got mine this October as I have every year since they became available. No matter how old you are, the experts recommend annual flu shots for people with diabetes.

Pneumonia Shots
All adults with diabetes need to get the pneumococcal vaccine at least once in their life. And when you reach 65 you need to a revaccination if you were vaccinated before you were 60.

Regular Blood Pressure Measurement
The American Diabetes Association doesn’t precisely say how often you need to be tested for high blood pressure (hypertension). It says instead that every time you go to the doctor’s office, you need to have it tested. In my experience, even though I have had low normal blood pressure all my life, this is a routine part of a visit to a doctor’s office. And if your blood pressure is not well controlled, you can buy a home blood pressure instrument and test your blood pressure even more often.

Annual Cholesterol Testing
Everyone is getting more and more concerned about high cholesterol. Acceptable levels have now been set so low that almost everyone with diabetes has a level that’s too high. Most people need to make sure that labs test their cholesterol at least once a year and more often if your numbers are too high. The exception is those lucky few who have low cholesterol. They need to get it tested only every other year.

Annual Kidney Function

Until I reminded him, this is one test that my previous doctor forgot one year. All of us need an annual test for the presence of microalbuminuria, which checks our kidney function.

Annual Eye Exam

An ophthalmologist or optometrist needs to check your eyes for diabetic retinopathy once a year. In my experience the only problem is that for a few hours afterwards your eyes are so dilated that it’s hard to read. Instead, plan to listen to music or take a nap until the world is no longer too bright.

Regular Foot Exams
Your doctor needs to give you a comprehensive foot exam once a year. The doctor also has a responsibility to look at your feet every time you visit. In my experience you might need to remind your doctor to do this. But these recommendations aren’t enough for people with diabetes who have lost the ability to feel in any part of their feet. These people – those who have neuropathy – need to check their feet every day for even the slightest wound, and if they find one, immediately make an appointment with their doctor.

Sure, these are a lot of appointments to remember. In fact, you can’t remember them all, unless you have a photographic memory. You need to write them down on your schedule. If you take care of these facets of your life, you increase the odds in your favor that you will stay healthy longer.

This article is based on an earlier version of my article published by HealthCentral.

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