Essential diabetes tests and screenings from head to toe

Essential diabetes tests and screenings from head to toe

You’ve heard it many times from your doctor of the importance of keeping your blood sugar levels in check.  Maintaining good blood sugar control is vital for avoiding many of the potential health consequences associated with diabetes - heart disease, blindness, kidney disease, neuropathy, and gum disease.  Many of these have no symptoms making it necessary to have regular screening tests to catch them early when there is still time to intervene.

Here is a list of essential tests and screenings from head to toe that everyone with diabetes should do to stay on top of their health:

·      For Eyes – Dilated Eye Exam

To find any signs of retinopathy, a dilated eye exam is a must.  Dilated eye exams, a painless procedure performed by either an optometrist or ophthalmologist, is simply putting eye drops in your eyes to dilate your pupils.  Dilating the pupils allows your eye doctor to examine the back of the eye (the retina) looking for signs of diabetic retinopathy.  Diabetic retinopathy is the leading cause of blindness in people with diabetes.

How often?  - For people diagnosed with type 2 diabetes, they should have this procedure done shortly after the time of diagnosis.  For those diagnosed with type 1 diabetes, they should have it done within five years.  If your blood glucose is well controlled and you are free of any signs of eye disease, you can be checked every one to two years.  If any level of eye disease is detected, however, exams at least annually are recommended.

·      For blood glucose – A1C/eAG test

The A1C test is a measure of your average blood glucose level over the past 2-3 months.  Once they know what your A1C test is, they can calculate an estimated average glucose  - eAG - based on the A1C.  The target for an A1C test is to be below 7 percent or less than 154 mg/dl for an eAG. Some people will have lower or higher targets based on other factors, such as age or additional health conditions.

How often? – For people meeting their blood glucose goals, at least twice a year or every six months is recommended.  For those who are not meeting their target range or who have recently changed their treatment regimen, they should be tested four times a year or every three months.  Pregnant women who have gestational diabetes may need to be tested even more frequently.

·      For the heart – blood pressure and cholesterol testing

Anyone with diabetes has a two times greater risk of heart disease making them more likely to be a victim of a heart attack or stroke.  A blood pressure level of 130/80 mmHg and above is considered too high. There are medications that lower blood pressure that are recommended for people with diabetes. 

How often should blood pressure be taken? – Every time you visit your doctor.

To check cholesterol, a blood test will be done to measure total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides.  If your LDL cholesterol is high, this puts you at an increased risk of heart disease.  If over the age of 40, your doctor may recommend a cholesterol lowering medication such as a statin.  Having a high HDL is good and is associated with a lower risk of heart disease. Men with an HDL less than 40 mg/dl and women with an HDL less than 50 mg/dl, should take steps to increase exercise and focus on healthy eating.  Excess triglycerides in the blood can cause clogged arteries.  If your level is above 150 mg/dl, your doctor may want to prescribe certain medications and discuss with you making lifestyle changes. 

How often to check cholesterol? – At least annually for those taking statins.  For anyone who is not on a statin medication or other lipid-lowering therapy, then at least every five years. 

·      For kidneys – Serum creatinine/eGFR and urine albumin-to-creatinine ratio tests

The serum creatinine test is a blood test to measure creatinine which is an indicator of kidney disease.  The estimated glomerular filtration rate (eGFR) is calculated from factors such as age, gender, race, weight, and the creatinine measure to determine if your kidneys are working properly.  An eGFR less than 60 ml/min/1.73 m2  indicates you have impaired kidney function.  The urine albumin-to-creatinine ratio test measures a protein called albumin in the urine.  If the results are greater than 30 mg/g this can indicate diabetic kidney disease. 

How often? – At least once a year if you have high blood pressure or type 2 diabetes or if you have had type 1diabetes for five years or more. 

·      For legs – ankle-brachial index test

The purpose of this test is to check for peripheral artery disease (PAD).  The test consists of using an inflatable cuff to measure blood pressure in your arm which is compared with blood pressure in your ankle. A normal result is between 0.9 and 1.3, according to the National Heart, Lung, and Blood Institute.  

How often?  - While there is no set schedule, an ankle-brachial index test should be performed when symptoms of PAD appear.

·      For feet – Foot evaluation

This exam is done by your doctor by visually examining your feet, checking for abrasions, ulcers (open sores), wounds, and signs of nerve damage (neuropathy), such as loss of ankle reflexes and loss of sensation in your feet and toes.  It is highly recommended for you to do daily foot exams at home of your feet with a mirror.

How often? – A comprehensive foot exam should be done at least once a year and inspections of your feet at every visit.  If you’ve had an ulcer, numbness or PAD in the past, you will need this exam done more frequently. 

·      For overall health – Body Mass Index (BMI)

This screening, which consists of being weighed on a scale, is a ratio of your weight to height used to determine if you are overweight to obese or how close you are to a healthy weight range for your height.  A BMI greater than or equal to 25 to 29.9 is considered to be overweight while a BMI of 30 or greater is considered to be obese. 

How often? – At every doctor visit.