When you're first diagnosed with diabetes, your healthcare provider (HCP) will check several tests to make sure that your medications and lifestyle changes are working to keep your blood sugar levels under control and to help catch early stages of diabetes complications. And because diabetes affects all systems in your body, you’ll likely receive tests that involve everything from your eyes to your heart to your feet.
Here are some of the most common tests, along with why you'll need them and how frequently they should be checked.
Tests at routine medical appointments
Diabetes and high blood pressure often occur together, and they often worsen each other. For this reason, blood pressure is measured at your regular diabetes exam every three to six months and at any healthcare visit. A reading of less than 120/80 mm Hg is considered normal by the American Heart Association, but since treatment guidelines may vary you should ask your HCP for the target numbers that are best for you.
Because maintaining a weight that is healthy for you is also key to preventing diabetes complications, your HCP may also weigh you at every visit.
Specific exams you’ll likely need
Eyes: Because complications from diabetes can affect vision, even leading to blindness in some cases, you should also have an annual eye exam. If you already have a diabetes-related eye condition, you will see your eye doctor more frequently.
Feet: One potential complication of diabetes is loss of feeling in the feet, which can put you at risk for foot injuries, including cuts or sores that you may not realize you have. Diabetes can cause poor circulation, which makes it harder for sores to heal and can lead to further complications.
Ask for a foot check at each healthcare visit. You should also examine your feet yourself, every day if possible, and check for for redness, broken skin, blisters, warm spots or swelling.
Your feet can also provide an indication about the health of your overall circulation and nervous system. At least annually, your provider should check your pulse and nerves at the ankle and your foot reflexes.
Routine blood tests
HbA1c: One of the tests involved in your diagnosis of diabetes will also play a role in monitoring your blood sugar levels. This test, called HbA1c, measures how much of your hemoglobin has glucose bound to it. (Hemoglobin is a substance in your red blood cells that shuttles oxygen from your lungs throughout your body.) Results from the test show how well your blood sugar has been controlled in the preceding three months.
The ideal target value of this test will vary depending on your specific situation, but a common goal is to have a HbA1c of less than 7 percent. Values above your target indicate that your blood sugar is not well-controlled. The HbA1c test can be done in a provider's office or lab or sometimes with a kit at home. If you have questions about what type of test is covered by your insurance, ask your provider.
Fats: Levels of cholesterol (a fat-like substance in the blood) are tested at least every five years, and more often depending on your personal situation. Imbalances in cholesterol are tied to heart disease and stroke, both leading causes of death for people with diabetes.
These tests are done after fasting (not eating) overnight. For patients with diabetes, the recommended level of total cholesterol is generally less than 200 mg/dl. Levels of low-density lipoprotein (LDL, or "bad" cholesterol) should be less than 100 mg/dl. For patients who are already at risk for heart disease, a lower LDL target of 70 mg/dl or less is often recommended.
High-density lipoprotein (HDL, or "good" cholesterol) level are generally recommended to be 50 mg/dl or more for women, and 40 mg/dl or more for men. Triglycerides (another type of fat in the blood) should generally be less than 150 mg/dl.
Checking for kidney function
Diabetes can be hard on the kidneys, which can become damaged by high blood sugar levels and high blood pressure that often occurs with diabetes. In fact, the leading cause of kidney failure in the United States and Canada is diabetes. For this reason, each year, your HCP will check your urine for signs of kidney disease.
The kidneys filter wastes from the body, and help balance fluids, minerals, and other substances in your blood. Healthy kidneys do not allow protein from your blood to enter your urine. Your HCP will routinely check your urine for a protein called albumin, which the liver produces. The presenceof this protein in the urine indicates that the kidneys may be damaged.
Your HCP will also check a blood test to look for a substance called creatinine, a waste product that naturally occurs in your body as the result of normal body functions. Healthy kidneys filter out creatinine, but when the kidneys are damaged it builds up in the blood. The creatinine level is used along with several other factors—including your age, sex, and race—to calculate the estimated glomerular filtration rate (eGFR). A low eGFR indicates decreased kidney function, and can indicate whether kidney disease has developed.
