Excellent diabetes care requires careful attention to self management and knowledge about what to expect from your physician. At every visit, your physician 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 physician to prescribe certain medications to reduce your chances of having heart or kidney disease.
Other annual recommendations include:
- A dilated eye exam.
- A test for peripheral neuropathy (nerve disease).
- Visits with a diabetes educator and a nutritionist every 3-6 months (depending on glucose control) one should have a hemoglobin A1c level test, a blood test which measures blood sugar control for the previous 12-16 weeks. The target for your A1c is to be as close to the normal range as possible (usually 6-6.5%).
The physician visit
Regarding blood pressure, your goal should be to have your pressure less than 130/80. 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.
Your physician should also review your home glucose monitoring values 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 patients taking insulin, the minimum frequency of testing should be no less than four times daily. For patients not treated with insulin, the frequency should be at least daily (although once or twice a week it is beneficial to have four blood sugar levels measured each day).
If your physician follows a set of practice guidelines other than those endorsed by the American Diabetes Association (ADA), you should be able to see a copy of them. You may receive more information about the guidelines from the ADA by calling them at 1-800-DIABETES.
