Diabetics need to undergo some tests apart from regular glucose monitoring to detect and treat complications, if any, at the earliest stage. These include:
Blood pressure measurement
High blood pressure is a common co-existing disorder in people with diabetes—in fact almost 50 per cent of diabetics have it. This deadly combination increases the risk of heart diseases and stroke by up to 75 per cent. By keeping blood pressure [BP] in check, diabetics can avoid serious complications such as heart failure, strokes, kidney and eye disease.
BP measurement is recommended at every doctor's visit. People with diabetes should aim for BP readings of 130/80 mmHg or less.
Lipid profile screening measures low-density lipoprotein [LDL], high-density lipoprotein [HDL] cholesterol as well as triglycerides. Research indicates that high levels of lipids increase the risk of heart disease.
People with diabetes are recommended to have a lipid profile screening at least once in a year. They should aim for an LDL level of less than 100 mg/dl, HDL [good cholesterol] of more than 40mg/dl for men, and more than 50mg/dl for women and triglycerides level under 150mg/dl.
Lipid abnormalities can be modified through a good nutrition plan, weight loss, physical activity, controlled blood glucose levels and a range of medications.
Diabetic retinopathy is the most common eye disease amongst diabetics, which can lead to vision loss. You can have diabetic eye disease and not know it as it is painless and often has no symptoms. Although there are a variety of treatments for diabetic retinopathy, the earlier it is diagnosed the more effective is the treatment.
People with diabetes are recommended to have their eyes checked annually through a dilated eye exam [where the doctor places drops in eyes] to examine the retina [the inside of the eyes].
Diabetes is a leading cause of kidney failure and about 20 – 40 per cent of diabetics develop kidney disease. The earlier you catch the signs of kidney disease the better it is for doctors to minimise damage to kidneys by medication.
Tests like urine microalbuminurea and serum creatinine are recommended once in a year to detect any evidence of kidney disease. These tests detect if the kidneys are leaking small amounts of protein. Ordinarily, there should be no protein in the urine, but in diabetes, one of the first indicators that something's wrong with the kidneys is the presence of small amounts of protein.
The normal albumin level in the urine is less than 30mg. Anything that is persistently above that is abnormal and reflects an early sign of kidney disease. The normal serum creatinine values range from 0.6 – 1mg per cent.
Research shows 25 per cent of people with diabetes develop foot problems. You can develop different types of foot problems, but if left untreated, all lead to serious complications.
Diabetes can damage the nerves, causing loss of ability to feel pain or discomfort. This is called diabetic neuropathy. It also causes circulation problems, which lead to delayed healing.
Hence, it is important to examine feet at least once a day for cuts, blisters, sores, in-growing toe nails, any sign of infection or damage. It is advised that diabetics get their feet checked by a physician at least once annually.
See the dentist every six months for a thorough dental screening. Know what tests you need to check for complications of diabetes.
You may need some tests more often than indicated or may also need to consider advanced tests.By following the above test schedule dedicatedly, a diabetic can enjoy a healthy, normal and long life.
Seeking regular medical advice and learning as much as possible about diabetes is an essential part of diabetes management. Other than the tests mentioned in the article, it is also important to monitor sugar levels regularly and keep a check on the medications.
Blood sugar monitoring
There are two ways of doing it:
SMBG [Self monitoring of blood sugar levels] : In this case, the frequency of testing blood sugar levels can range from two times in month to 6 – 7 times in day. Pregnant women and people with infections need to check their blood glucose more frequently. It is essential to write down each result, along with the time and date, to make appropriate changes in treatment regime, if required.
HbA1c: This reflects average blood glucose control for the last 2 – 3 months period. The higher the HbA1c, the greater is risk for developing complications. This test is recommended every 3 – 6 months. A person with normal blood glucose levels should have an HbA1c between 4 – 6 per cent. In diabetics, HbA1c is aimed at less than seven per cent.
In most cases, people with type-2 diabetes require oral drugs. Also, if HbA1c is below seven per cent insulin may be prescribed. There are mainly two types of insulin—conventional human insulin and modern insulin analogues. New therapies such as GLP-1 analogues in addition to controlling diabetes, also lower systolic blood pressure, improve beta cell function and aid in weight loss.
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