Diabetes: Tests You Need and Why
Diabetes is a condition that can affect your whole body. When your blood glucose stays too high for too long, it can lead to problems with your heart, blood vessels, eyes, nerves, and kidneys. By getting regular tests and checkups, you can help control your glucose level and prevent or delay damage caused by high blood glucose. Watching your health closely lets you react to problems early before they get more serious.
Here’s a list of several diabetes-related tests and checkups, as well as guidelines for how often each is needed. Keep in mind that you may need more frequent testing or checkups if you have signs of problems. Your healthcare provider can suggest the best schedule for you.
This blood test shows the average amount of glucose in your blood during the past 2 to 3 months. The results show how well your blood glucose is controlled and if your treatment plan needs any changes. The A1C target level for many people is less than 7%. But this target level may vary depending on your age, how long you have had diabetes, and other risk factors.
How often: At least 2 times a year if you are at your goal with stable glycemia. More often if your therapy has changed or you're not meeting glycemic goals. Your healthcare provider may suggest a few weeks of continuous glucose monitoring to possibly find dangerous trends that even multiple blood sticks per day may not find. Examples are periods of dangerously low blood sugars from too high doses of some medicines.
Blood lipids test
This blood test checks for several types of fat in your blood. LDL (bad) cholesterol can narrow or block blood vessels. This can possibly lead to a heart attack or stroke. These are big problems for people with diabetes. Most people with diabetes will be advised to eat a low-fat, heart-healthy diet and take statin medicines to lower cholesterol levels. Your total cholesterol should be lower than 200 mg/dL. And your LDL level should be lower than 100 mg/dL. If you have both diabetes and cardiovascular disease, your LDL level should be lower than 70 mg/dL. Triglycerides are another type of harmful fat that raise your risk for heart attack and stroke. Aim for a fasting triglyceride level lower than 150 mg/dL. HDL (“good”) cholesterol helps keep your blood vessels healthy. Your HDL level should be higher than 40 mg/dL for men. Or higher than 50 mg/dL for women.
How often: At least once a year
Blood pressure test
Controlling your blood pressure helps prevent heart, blood vessel, eye, and kidney problems. The target for adults with diabetes is a blood pressure reading lower than 130/80 mm Hg. Both numbers matter. The first is the pressure as your heart beats and pushes blood into your blood vessels. The second is the pressure as your heart rests between beats.
How often: At every healthcare provider visit. You can check your own blood pressure at home and keep a record of it to show to your provider at your appointment.
Having diabetes puts you at higher risk for tooth and gum problems. So it’s very important to have your teeth cleaned and checked at your dentist’s office on a regular basis. At each dental visit, give your dentist a list of your current medicines and how much you take of each.
How often: At least twice a year
Dilated eye exam
High blood glucose and high blood pressure can harm the eyes. In a dilated eye exam, an eye care provider puts drops in your eyes to briefly enlarge your pupils. This makes it easier for the provider to look inside your eyes for signs of damage. Often photos are taken to document any eye damage and to compare findings from previous exams.
How often: Once a year by a licensed ophthalmologist or optometrist
Nerve damage, poor blood flow, and infections due to diabetes can cause foot problems. Nerve damage can lead to a loss of feeling in the feet, putting you at risk for injuries and falls. Or it can cause ulcers to develop. Poor circulation can mean that sores or infections heal slowly. If these problems aren’t treated right away, they can lead to serious infection or amputation. At every healthcare provider visit, have your feet checked for sores. In addition, you should check your feet every night for redness, injuries, or blisters. And you should have a full foot exam each year. Your provider should check the integrity of your skin, the status of your toenails, and the feeling and circulation in your feet.
How often: Daily foot self-exams and a comprehensive foot exam by your provider once a year
Kidney function tests
Diabetes can damage the kidneys and over time cause kidney failure. Various tests can help find kidney problems before they become severe. One test checks for a protein called microalbumin in the urine, an early sign of kidney disease. Another test checks for creatinine in the blood, a waste product that builds up when the kidneys aren’t working correctly.
How often: 1 to 3 times a year, depending on how the kidney disease is progressing.