Diabetes Doctors: Raising Your Standards & What to Expect
How often should I see my doctor about my diabetes?
People with diabetes who are treated with insulin should generally see their doctor at least every three to four months. People with diabetes who are treated with oral medications or who are managing diabetes through diet should be seen at least every four to six months. More frequent visits may be necessary if the patient's glucose (blood sugar) is not controlled or if complications of diabetes are increasing.
What information should I give my doctor about my diabetes?
Generally, your doctor needs to know how well your diabetes is being controlled and whether diabetic complications are developing or increasing. Therefore, at each visit, give your doctor your home glucose 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 medications, and of any new illnesses that may have developed. Tell your doctor if you have experienced any symptoms of eye, nerve, kidney, or cardiovascular complications, such as:
- Blurred vision
- Numbness or tingling in your feet
- Persistent leg swelling
- Chest pain
- Shortness of breath
- Numbness or weakness on one side of your body
Your weight and blood pressure should be measured at each visit. Your eyes, feet, and insulin injection sites should also be examined at each visit.
What lab tests should I have done for my diabetes, and how often?
The hemoglobin A1c is an important blood test to determine control of your diabetes. It provides an average blood sugar measurement over the previous six to 12 weeks and is used in combination with home glucose monitoring to make adjustments to your treatment. People with diabetes who are treated with insulin should have this test two to four times a year, depending on whether those patients are meeting therapy goals.
People with diabetes may need to have the hemoglobin A1c test more frequently when their diabetes is not controlled. However, the test should be performed no sooner than every six weeks.
To screen for diabetic kidney complications, a urine test for protein (urinalysis) should be done every year, beginning at diagnosis in people with Type 2 diabetes, and after five years in people with Type 1 diabetes. If the results of a urinalysis are negative for people with Type 1 diabetes, microalbumin (which detects very small amounts of protein) should be checked every year.
People with diabetes should have their cholesterol level (including HDL, LDL, and triglyceride levels) checked every year if their cholesterol level is abnormal, or every two years if their cholesterol level is normal.
How can I keep an eye on the development and progression of diabetic complications?
Eye disease (retinopathy)
All patients with diabetes should see an ophthalmologist (specialist in eye disease) every year for a dilated eye examination, beginning at diagnosis. Patients with known eye disease, symptoms of blurred vision in one eye, or blind spots may need to see their ophthalmologist more frequently.
Kidney disease (nephropathy)
Urine testing should be performed every year. 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 at 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 or tingling 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, let your doctor know immediately.