Tests and Visits
Tests and Visits
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Thursday, January 01, 2004 |
Q: "The Diabetes Standards of Care mention regular lab and blood pressure checks, but what are the specific goals and frequency?"
A: Below are recommendations from the American Diabetes Association (ADA), the National Diabetes Education Program (NDEP) and the American Association of Diabetes Educators (AADE).
Education: Diabetes education is a continuous process. It is often said that diabetes management is 95% self-management skills.
- Suggested frequency: While there is no official recommendation on the frequency of education visits, many experts recommend at least a yearly visit with a diabetes nurse educator and dietitian.
Glucose Monitoring: You can’t manage what you don’t monitor. Glucose monitoring helps you achieve and maintain your target range, while showing you the effects of medication, food, activity, stress and illness on your blood glucose. Studies have shown that people who test regularly have lower A1Cs than people who don’t test or who test infrequently.
- Suggested goals and frequency: Both the target goals and the frequency of testing are individual, and should be determined with your diabetes team. Please refer to the related questions below.
A1C: This is the test that measures your average blood glucose over the past 3 months.
- ADA suggested target: below 7. It is further explained that the goal is to be as close to normal (<6%) as possible without significant hypoglycemia.
- Suggested frequency of testing: The ADA recommends at least every 6 months for those in stable control; however, if your therapy has changed or if you are not meeting target goals, then it should be done every 3 months. Naturally, the frequency of this test depends on your treatment regimen as well as the judgment of your healthcare team.
Blood Pressure: High blood pressure can increase your risk of a heart attack, stroke, kidney complications, and other problems.
- The ADA target goal is below 130/80.
- Suggested frequency of testing: This is individual and should be determined with the help of your diabetes team.
Cholesterol and Triglycerides: While many people have heard about cholesterol, they are not always aware of the different types—one is "good" and one is "bad." LDL cholesterol is the "bad" cholesterol, which deposits in the walls of arteries and can lead to heart disease and strokes. HDL is the "good" cholesterol, which carries blood cholesterol back to the liver, where it can be eliminated. HDL helps prevent a cholesterol buildup in blood vessels. Low HDL levels increase heart disease risk. Triglycerides are the body's main storage form of fat. Elevated triglyceride levels are linked to heart disease as well.
- The ADA target goal for LDL is: Below 100.
- The ADA target goal for HDL is: Over 40 for men and over 50 for women.
- The ADA target goal for triglycerides is: Under 150.
- Suggested frequency of testing: This is individual but should be done at least once a year.
Aspirin Therapy: Taking low-dose aspirin every day can help prevent heart attacks and strokes. Recommendations vary depending on your age and health conditions so check with your doctor before starting daily aspirin.
Kidney Tests: Kidneys can become damaged from poorly controlled diabetes as well as from high blood pressure. Normally there is little or no protein in the urine. Increased amounts of protein indicate reduced kidney function. Testing for small amounts of protein in the urine (called a microalbumin test) can detect kidney disease very early so that measures can be taken to slow or stop the progression of kidney disease.
- The ADA suggested target for microalbumin is: below 30 mg/24 hours.
- Suggested frequency of a microalbumin test: At least yearly.
Eye Exams: Regular eye exams can spot retinopathy (eye disease) early enough to preserve vision and prevent blindness. Keeping both your blood pressure and your blood glucose in control can greatly reduce eye complications. Usually there are no early warning signs of eye disease, so it is important to have regular exams.
- Suggested frequency of an eye exam: At least once a year.
Foot Exams: Check your feet daily. If you have nerve or vascular disease, you might not feel an injury, and poor circulation will delay healing.
- Suggested frequency: Check your feet daily. Remind your doctor to check your feet at every visit (take your shoes/socks off as soon as you enter the examining room). Get an extensive foot exam yearly.
Exercise: Although it is not part of the recommended tests or visits, exercise is well recognized as an important aspect of diabetes care. Refer to related question below.
Vaccinations: A final aspect of staying healthy is doing all you can to avoid getting sick. Illness can cause your diabetes to get out of control; then, high blood glucose might delay healing and lead to other complications.
- Suggested frequency: Flu vaccine, every year. Pneumonia vaccine, at least once in a lifetime but revaccination is recommended under certain conditions. Check with your healthcare team.
Related Questions
Controlling Lipids (blood fats)
Q:
"I have type 2 diabetes treated with Amaryl. Now my doctor has added
Lipitor. What does Lipitor do?"
Postprandial (Post-Meal) Glucose
Q:
"I have type 2 diabetes. In class much emphasis was put on the blood sugar
2 hours after I stop eating. Why is this so crucial?"
Foot Care
Q:
"Would you explain foot care?"
Why test if not on diabetes medication?
Q:
"I have Type 2 and am getting high numbers when I test. A type 1 can take
insulin if high. What can I do to lower my number? Almost seems senseless to
test if I cannot take action to remedy the results..."
Glucose Goals
Q:
"What is a good blood glucose reading?"
How much exercise?
Q:
"What is considered an adequate amount of exercise? I don’t exercise, but
now that I have diabetes, I think I should."
Related Links
American Association of Diabetes Educators (AADE)
http://www.diabeteseducator.org
American Diabetes Association (ADA)
http://www.diabetes.org
National Diabetes Education Program (NDEP)
http://www.ndep.nih.gov
American Heart Association
http://www.americanheart.org
National Diabetes Information Clearinghouse (NDIC)
http://diabetes.niddk.nih.gov
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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