Routine checkups in Diabetes

Diabetes is a metabolic disease and high sugar or glucose is one of its components. Very often, common enemies like blood pressure, high cholesterol, and Diabetes travel together. These 3 as a group then cause damage to various organs of the body. These Diabetic complications are preventable if a patient keeps his or her chemistry in a normal range. To keep all parameters in the normal range, it is important to check them periodically.

Routine checkups aim to monitor Glucose trends, lipid trends, Blood pressure goals and to have a watch on diabetic complications, particularly for the eyes, kidneys, nerves, and heart.

Following is a summary of tests recommended for Diabetic patients by all international organizations:

Test of Glucose control

1. Serum glucose fasting: Lab – at least once a month
2. Serum glucose Post Prandial: Lab – at least once a month
3. Self Monitoring of Blood Glucose or more times daily for patients using multiple insulin injections or insulin pumps. At least once a day for a patient’s on insulin therapy. At least once a week for the patient’s on oral drugs or diet treatment
4. HbA1C: Every 3 months in patients whose therapy has changed or who are not meeting glycemic goals.Every 6 months in patients who are meeting treatment goals  Lipid Profile

Lipid Profile
At least once a year.
[In adults with low risk lipid values (LDL Cholesterol < 100 mg/dl, HDL cholesterol > 50 mg/dl, and triglycerides < 150 mg/dl), lipid assessments may be repeated every 2 years ]
Test of Kidney Function
Perform an annual test to assess urine albumin excretion in type 1 diabetic patients with diabetes duration of ≥ 5 years and all type 2 diabetic patients, starting at diagnosis.
Serum creatinine at least annually (Should be used to estimate GFR) Urine Albumin excretion (to detect microalbuminuria) once a year. For type 1 diabetes above tests to be done when the diabetes duration is ≥ 5 years.

Blood Pressure
It should be measured at every routine diabetes visit.

Eye and Retina
Dilated comprehensive eye examination at the time of diagnosis and then continue every year.

For type 1 diabetes Dilated comprehensive eye examination to be done when the diabetes duration is ≥ 5 years.

CARDIAC [HEART] TESTING:
For Patients with a sedentary lifestyle, age more than 35 years, more than 2 cardiac risk factors, Cardiac stress test may be considered.

Neuropathy Screening
Every year screening using simple clinical tests is needed.

Foot Evaluation
Every year comprehensive foot examination should be done to identify risk factors.

Thus with help of the above-mentioned tests, a complete evaluation of a patient can be performed, and accordingly, treatment may be planned to take care of high glucose as well as other risk factors.