Excellent diabetes care requires careful attention to self management and knowledge about what to expect from your healthcare provider. At every visit, your healthcare provider should measure your blood pressure and give you a thorough foot examination. Annual laboratory measurements that should be performed include:
- a fasting lipid profile (cholesterol, low density lipoprotein level, high density lipoprotein level and triglyceride level)
- a urine test for protein
- a test for kidney function
The results of these measurements may prompt your healthcare provider to prescribe certain medications to reduce your chances of having heart or kidney disease. Other annual recommendations include:
- a dilated retinal eye exam
- a test for peripheral neuropathy (nerve disease)
- visits with a diabetes educator and a nutritionist
- A1c level should be checked every 3-6 months (depending on glucose control). This is a blood test which measures blood glucose control for the previous 2-3 months. The target for your A1c is to be as close to the normal range as possible (usually less than 7%).
THE PHYSICIAN VISIT
Your blood pressure should be less than 130/80 mm of Hg. You may need medications to maintain your blood pressure in this range, and the medication of choice for people with diabetes and hypertension is called an ACE inhibitor (due to its protective effect on the kidneys).
Your healthcare provider should also review your blood glucose monitoring values with you at every visit. Depending on the results, changes in your medications may be made to improve your blood glucose control. Self-monitoring of blood glucose is known to help improve blood glucose control. For people taking insulin, the minimum frequency of testing should be no less than four times daily. For people not treated with insulin, the frequency should be at least daily.
