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Diabetes Regular Check Up

How often do you need to visit your health care team and why?


By Nina Nazor

Periodic testing will help you detect any early signs of complications so you can prevent or delay the progress of problems such as the development of kidney disease, eye disease, cardiovascular disease or wounds in your feet.

Blood pressure

Your doctor must check your blood pressure in every visit. Normal blood pressure is 120/80 mmHg. If you have diabetes you should have below 130/80 mmHg. If you have been diagnosed with hypertension or high blood pressure then work with your doctor to achieve that goal and you will decrease your risk of cardiovascular disease.

Glycosylated hemoglobin test (HbA1C)

This test shows you how well you have controlled your blood glucose levels during the preceding 3 months. You must have it every three months. The goal is to have an A1C level below 7%.

Blood lipids (fats)

Cholesterol and triglycerides are some of the fats in the blood. Cholesterol is a fatty substance that needs vehicles to be transported through our blood. This vehicles are called "lipoproteins", molecules comprised of protein and fat where cholesterol can be transported.

The so-called "bad cholesterol" (Low Density Lipoproteins or LDL) are the vehicles that go from the liver to our tissues filling them with cholesterol and contributing to build cholesterol plaque. The "good cholesterol" (High Density Lipoproteins or HDL) particles are the ones transporting cholesterol from our arteries and tissues to the liver, where it should be used to produce hormones and other compounds.

When you get a lipid profile at the lab, you get the number of total cholesterol, and also the number of good ones and bad ones, the important point here is to have more good ones and less of the bad ones.

The recommended values of cholesterol are:

·  Total cholesterol: under 200 mg/dL

·  LDL: below 100 mg/dL

·  HDL: above 50 mg/dL

·  Triglycerides: below 150 mg/dL

Usually a lipid panel is recommended once a year, but your doctor will let you know how often to have it depending on your current levels of your fats in blood.

Foot exams

At least once a year you must visit your podiatrist; he/she will evaluate your feet to assess the risk for complications like nerve damage and vascular problems. A foot examination consists of checking your pulses, sensation, evaluating the general structure of your feet, and evaluating the presence of abnormalities in your skin and nails. This helps the podiatrist determine your risk for developing complications in your feet. Learn about how to take care of your feet.

Eye exams

High blood glucose levels can damage the blood vessels in the retina, in the back of the eye, which are thinner than a hair. If you have diabetes you must see an ophthalmologist once a year for a dilated eye exam. The doctor will evaluate the deep of your eyes in search of signs of diabetic retinopathy, glaucoma or cataracts.

Microalbuminuria or urine protein test

Millions of small blood vessels in the kidneys are in charge of cleaning your blood from waste and toxic substances. These tiny vessels, much smaller in diameter than a hair, are damaged by high blood glucose levels, which affect the filtering capacity of the kidneys and increase the risk for developing kidney failure, for which dialysis or kidney transplantation are the only treatment.

When the kidneys are not filtering well, as they should, small amounts of the protein albumin pass through the urine. This condition is called microalbuminuria. You should have a microalbuminuria test every year.

Vaccines

Every person with diabetes must have a flu shot each year. Flu shots may help reduce your risk of catching the flu for about 6 months. Also, it is recommended that people with diabetes get a pneumonia shot. Although for most people one shot is enough protection for a lifetime, you must ask your doctor about getting another shot 5-10 years after their first one.

Electrocardiogram (ECG)

This test measures the activity of the heart and will tell your doctor if you heart is working fine. You should have an electrocardiogram when you are diagnosed with type 2 diabetes or once a year if you already have a diagnosis of type 1 or type 2 diabetes.

Urine tests

Urinary tract infections are frequent in people with diabetes, especially if they are not properly controlled. Each time you see your doctor for a regular check up you should have your urine tested to find the presence of bacteria as well as white and red blood cells.

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