Diabetes does not just affect a person’s blood glucose levels, but it also impacts other parts of the body, such as kidneys, eyes, and even feet. To lower your risk for diabetes-related complications, it’s important to maintain good control — and have these routine tests during your visit with your healthcare team to check on how you’re doing.
An A1C test, also called a glycohemoglobin or hemoglobin A1C, is the best way to measure your overall blood glucose control over a two to three month period. The A1C test can be done on a sample of blood collected from a finger stick, or from a small vial of blood drawn from the arm. Joslin recommends that this test be done every three to six months. A person without diabetes would have an A1C between 4 and 6 percent. For people with diabetes, Joslin recommends aiming for an A1C of less than 7 percent, as long as achieving this goal does not increase the risk for developing low blood glucose (or blood sugars), called hypoglycemia. Keeping your A1C in the target range is an effective way to decrease your chances of developing diabetes-related complications, so be sure to always ask your healthcare provider what your A1C target should be.
To schedule your annual A1C test, click here.
People with diabetes are at a higher risk of developing foot problems due to decreased circulation and lack of feeling in the foot from high glucose levels. A common foot complication is diabetic neuropathy, which typically occurs when nerves in your feet become damaged, resulting in the inability to feel pain or discomfort from injuries or sores. Diabetes can also cause circulation problems that prevent you from healing as quickly as people without diabetes do.
Joslin recommends that you have your feet checked at least annually – and preferably at every medical visit — for altered sensation, decreased circulation or infection. During the exam, the doctor will perform a visual inspection and look for skin color changes, cuts, and other damages. The doctor will also take a pulse at key points of the foot to determine circulation levels. There will be a test of sensation, where the doctor uses a tuning fork, pinwheel, or tin gram fiber to evaluate awareness of touch, dull versus sharp pain, and movement of the tool across the skin.
To schedule your annual foot exam, click here.
Diabetic eye disease is painless and often has no symptoms until advanced stages, meaning many people with diabetes can have the disease and not even know it. Diabetic retinopathy is the most common eye disease for people with diabetes and occurs when the small blood vessels in the eye are damaged by high levels of glucose in the blood. Diabetes also puts people at risk for cataracts, glaucoma, and other complications.
The earlier diabetic eye diseases are diagnosed, the more that can be done to halt vision loss. Serious eye damage can prevented if complications are found early, so it is important to get an eye exam annually. The exam can take up to two and a half hours, and includes dilating the pupil to be able to see the back of the eye. The entire exam is painless, but you should be prepared to wear sunglasses after the appointment as your pupils will become sensitive to light after they are dilated.
To schedule your annual eye exam, click here.
High blood pressure is more common in people with diabetes, and controlling your blood pressure is essential in preventing serious complications such as heart failure, stroke, or eye and kidney disease.
Joslin recommends that you have your blood pressure measured at every medical visit. The suggested blood pressure goal is less than 140/90 mmHg for people under the age of 18 and less than 130/80 mmHg for individuals without cardiovascular disease or multiple risk factors. If you already have complications due to diabetes, such as kidney disease, your blood pressure goal may be different. Be sure to ask your healthcare provider what your goal should be.
To schedule your blood pressure test, click here.
There are two types of kidney exams that should be performed annually. The first is a special type of urine test that tracks excess protein in the urine, a condition known as microalbuminuria. The normal albumin level in the urine is less than 30 mg. Anything above that is abnormal and reflects an early sign of kidney disease. The second test is a blood test that measures the blood creatinine level. The creatinine is a substance that is always in the blood, but when there is kidney failure, the level of this substance will rise. By checking the glomerular filtration rate of your kidneys, your doctor can tell how well your kidneys are filtering your blood. Remember to always ask your doctor what your GFR is.
To schedule your annual kidney test, click here.
With these five tests and proper diabetes management, diabetes-related complications can be prevented or, if found, better treated. For more information on these five essential tests, visit Joslin’s Adult Clinic.