Diabetes - Management
Your healthcare team includes your doctor, dietitian, diabetes educator, exercise trainer, and pharmacist. But remember, you are the most important member of the team. Your health care team is available to help you manage your diabetes and maintain your good health. Cleveland Clinic also offers a number of Diabetes Education classes to help those with diabetes get on track to effective disease management.
NOTE: The American Diabetes Association publishes Clinical Practice Recommendations for health care providers. Standards of medical care for people with diabetes were most recently updated in 2012. Those guidelines, published in Diabetes Care, 2012, Volume 35, Supplement 1.
How often should I see my doctor?
People with diabetes who are treated with insulin shots generally should see their doctor at least every three to four months. People with diabetes who are treated with pills or who are managing diabetes through diet should be seen at least every four to six months. More frequent visits may be necessary if your blood sugar is not controlled or if complications of diabetes are worsening.
What information should I give my doctor?
Generally, your doctor needs to know how well your diabetes is controlled and whether diabetic complications are starting or getting worse. Therefore, at each visit, provide your doctor with your home blood sugar monitoring record and report any symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).
Your doctor also should be informed of any changes in your diet, exercise, or medicines and of any new illnesses you may have developed. Tell your doctor if you have experienced any symptoms of eye, nerve, kidney, or cardiovascular problems such as:
- Blurred vision
- Numbness or tingling in your feet
- Persistent hand, feet, face, or leg swelling
- Cramping or pain in the legs
- Chest pain
- Shortness of breath
- Numbness or weakness on one side of your body
- Unusual weight gain
At each visit, your weight and blood pressure should be measured. Your eyes, feet, and insulin injection sites should also be examined at each visit.
What lab tests should I have done?
- Hemoglobin A1c
- Urine tests
- Cholesterol and triglyceride levels
How can I monitor the development and progression of diabetic complications?
Eye disease (retinopathy)
All patients with diabetes should see an ophthalmologist yearly for a dilated eye examination--beginning at diagnosis in people with type 2 diabetes and in 3 to 5 years in people with type 1 diabetes after puberty. Patients with known eye disease, symptoms of blurred vision in one eye, or blind spots may need to see their ophthalmologist more frequently.
Women who have diabetes and become pregnant should have a comprehensive eye exam during the first trimester and close follow-up with an eye doctor during pregnancy (this recommendation does not apply to women who develop gestational diabetes).
Kidney disease (nephropathy)
Urine testing should be performed yearly. Regular blood pressure checks are important since control of hypertension (high blood pressure) is essential in slowing kidney disease. Generally, blood pressure should be maintained less than 130/80 in adults. Persistent leg or foot swelling may be a symptom of kidney disease and should be reported to your doctor.
Nerve disease (neuropathy)
Numbness, tingling, burning, or pain in your feet should be reported to your doctor at your regular visits. You should check your feet daily for redness, calluses, cracks, or skin breakdown. If you notice these symptoms before your scheduled visit, notify your doctor immediately.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/20/2012...#9823